摘要
目的 探讨静脉滴注氨溴索联合振动排痰机治疗呼吸机相关性肺炎（VAP）的临床疗效. 方法 选取本院重症医学科中行机械通气合并VAP患者96例,随机分为3组,每组32例.3组均予抗炎、吸痰、气道湿化、营养支持等常规治疗,对照组只接受常规治疗,氨溴索组在常规治疗基础上,辅以氨溴索30 mg加入生理盐水100 ml静脉滴注,3次/d,氨溴索＋排痰机组在氨溴索治疗基础上隔天采用美国G5振动排痰机行叩振排痰2次/d. 结果 3组患者在治疗前后急性生理学及慢性健康状况评分系统（APACHEⅡ）（F=5.736,P＜0.05）、氧合指数（PaO2）/FiO2（F=9.432,P＜0.05）、呼吸频率（F=6.361,P＜0.05）和心率（F=5.862,P＜0.05）值比较差异均有统计学意义.治疗后,上述各项指标APACHEⅡ（F=4.674,P＜0.05）、PaO2/FiO2（F=8.665,P＜0.05）、呼吸频率（F=7.351,P＜0.05）和心率（F=6.562,P＜0.05）组间两两比较差异均有统计学意义.治疗后3组临床有效率分别为71.9％、84.4％、93.8％,组间两两比较差异均有统计学意义（P＜0.05）. 结论 盐酸氨溴索静脉滴注联合振动排痰机治疗VAP效果显著,明显优于单一应用氨溴索静脉滴注.
Objective To investigate the clinical efficacy of combination therapy of ambroxol with vibration？ expectoration machine on ventilator-associated pneumonia Methods A total of 96 patients from the Department of Critical Care Medicine were selected and randomly divided into 3 groups：control group,ambroxol group and ammonia ambroxol ＋ vibration expectoration machine group （n=32,each）.The ventilator-associated pneumonia （VAP） was randomly divided into three groups （n =32,each）.All patients were treated with conventional therapy including anti-inflammatory,suction,airway humidification,nutritional support.On this basis,ambroxol group was given ambroxol 30 mg in 100 ml normal saline,intravenously dripped 3 times a day.On the basis of treatment in the ambroxol group,ammonia ambroxol ＋ expectoration machine were given G5 vibration expectoration machine to expectorate sputum 2 times every other day.Results There were significant differences in acute physiology and chronic health evaluation （APACHE Ⅱ）,PaO2/FiO2,respiratory rate （RR）,heart rate （HR） before versus after the treatment of the three groups （F =5.736,9.432,6.361,5.862,respectively,all P〈0.05）.After treatment in the three groups,APACHE Ⅱ,PaO2/FiO2,RR and HR showed statistically significant differences inter-group among three groups （F=4.674,8.665,7.351,6.562,respectively,all P〈0.05）.Clinical effective rates of the three groups were 71.9%,84.4%,93.8% respectively,and showed statistically significant differences inter-group among three groups （all P〈0.05）.Conclusions Combination therapy of ambroxol and vibration expectoration machine shows significant effects on VAP,and it is better than ambroxol alone.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2014年第8期871-873,共3页
Chinese Journal of Geriatrics
关键词
肺炎
呼吸机相关性
氨溴索
Pneumonia,ventilator-associated
Ambroxol
