大剂量泵注盐酸氨溴索对呼吸机相关性肺炎患者感染控制及预后的影响

发布时间：2018-04-25 11:05

本文选题：呼吸机相关性肺炎 + 大剂量　；参考：《中国药房》2017年03期

【摘要】：目的:观察大剂量泵注盐酸氨溴索对呼吸机相关性肺炎患者感染控制及预后的影响。方法:80例呼吸机相关性肺炎患者随机分为对照组(41例)和观察组(39例)。两组患者均给予吸氧、雾化、营养支持、维持机体稳态平衡等常规对症治疗,同时根据细菌培养结果进行抗菌治疗。在此基础上,对照组患者给予注射用盐酸氨溴索30 mg,静脉滴注,tid;观察组患者给予注射用盐酸氨溴索300 mg,静脉泵注,6 h内完成,qd。两组疗程均为2周。观察两组患者临床疗效,记录肺部感染(CPIS)评分、氧合指数、白细胞介素(IL)-6水平、急诊住院时间、机械通气时间及治疗期间不良反应发生情况。结果:观察组患者痊愈率、有效率显著高于对照组,急诊住院时间、机械通气时间显著短于对照组,差异均有统计学意义(P0.05)。治疗后,两组患者CPIS评分、IL-6水平显著低于同组治疗前,且观察组低于对照组;氧合指数显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。结论:大剂量泵注盐酸氨溴索治疗呼吸机相关性肺炎疗效好于常规剂量静脉滴注,可以加大对患者的感染控制力度,改善预后,且不增加不良反应的发生。
[Abstract]:Aim: to observe the effect of high dose pump injection of ambroxol hydrochloride on infection control and prognosis of patients with ventilator-associated pneumonia. Methods 80 patients with ventilator-associated pneumonia were randomly divided into control group (n = 41) and observation group (n = 39). The patients in both groups were given routine treatment such as oxygen inhalation, atomization, nutritional support, maintaining homeostasis and antimicrobial therapy according to the results of bacterial culture. On this basis, the patients in the control group were given 30 mg ambroxol hydrochloride for injection, and the patients in the observation group were given ambroxol hydrochloride 300 mg for injection, and the patients in the observation group were injected with ambroxol hydrochloride for 6 h. The course of treatment was 2 weeks in both groups. The clinical efficacy, CPIS-score, oxygenation index, interleukin-6 level, emergency hospitalization time, duration of mechanical ventilation and adverse reactions during treatment were observed in the two groups. Results: the cure rate and effective rate of the patients in the observation group were significantly higher than those in the control group. The emergency hospitalization time and the mechanical ventilation time were significantly shorter in the observation group than in the control group. The difference was statistically significant (P 0.05). After treatment, the CPIS score of the two groups was significantly lower than that of the same group before treatment, and the observation group was lower than the control group, the oxygenation index was significantly higher than that of the same group before treatment, and the observation group was higher than the control group, the difference was statistically significant (P 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P 0.05). Conclusion: high dose pump injection of ambroxol hydrochloride is more effective than routine intravenous drip in the treatment of ventilator-associated pneumonia, which can increase the infection control, improve the prognosis, and do not increase the occurrence of adverse reactions.
【作者单位】：四川省医学科学院/四川省人民医院急诊ICU;
【分类号】：R563.1

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