北京大学学报(医学版) ›› 2018, Vol. 50 ›› Issue (5): 840-844. doi: 10.19723/j.issn.1671-167X.2018.05.013

• 论著 • 上一篇    下一篇

布地奈德联合氨溴索氧化驱动雾化吸入预防成人开胸术后肺炎的临床疗效

李刚,王健生,秦思达,张佳,杜宁,张靖,孙欣,任宏△   

  1. (西安交通大学第一附属医院胸外二科, 西安710061)
  • 出版日期:2018-10-18 发布日期:2018-10-18
  • 通讯作者: 任宏 E-mail:dooopenit@163.com

Clinical study of the oxygen drive aerosol inhalation with budesonide and ambroxol in the prevention of adult post-thoracotomy pneumonia

LI Gang, WANG Jian-sheng, QIN Si-da, ZHANG Jia, DU Ning, ZHANG Jing, SUN Xin, REN Hong△   

  1. (Second Department of Thoracic Surgery,First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061, China)
  • Online:2018-10-18 Published:2018-10-18
  • Contact: REN Hong E-mail:dooopenit@163.com

摘要: 目的:探讨布地奈德联合氨溴索氧化驱动雾化吸入对于预防成人开胸术后肺炎的临床效果。方法:采用随机、开放、平行的病例对照试验,于西安交通大学第一附属医院胸外二科住院患者中选择符合研究标准的患者80例作为研究对象。入组患者随机分为实验组和对照组,实验组患者进行术前3 d的雾化吸入用药,采用氧化驱动布地奈德2 mg联合氨溴索60 mg雾化吸入,对照组术前不进行雾化吸入,各组患者术后治疗方案一致。结果:基线资料显示,两组间患者在性别、年龄、病种、吸烟情况等方面差异不具有统计学意义(P>0.05)。手术前12 h血气分析结果显示,实验组PaO2为(88.40±9.40) mmHg,PaCO2为(38.30±6.10) mmHg;对照组PaO2为(85.09±7.18) mmHg,PaCO2为(41.21±3.15) mmHg,两组P值分别为0.029和0.011,差异具有统计学意义。实验组40例患者中发生术后肺炎者3例,发生率为7.50%;对照组40例患者中发生术后肺炎患者10例,发生率为25.00%,P值为0.034,差异具有统计学意义。进一步分析不同病种及手术方式对术后肺炎发生率的影响,显示在实验组及对照组中,食管癌患者的术后肺炎发生率均较肺癌患者术后肺炎发生率低,差异具有统计学意义(P<0.05)。实验组中肺楔形切除术、肺叶肺段切除术及肺袖式切除术例数分别为2、21及1例,对照组中相应例数为2、21及2例。两组间,肺癌不同手术方式患者的术后肺炎发生率差异具有统计学意义(P<0.05)。结论:患者术前3 d应用布地奈德联合氨溴索氧化驱动雾化吸入进行呼吸道准备,可大大减低术后肺炎的发生率。

关键词:  , 布地奈德, 氨溴索, 雾化吸入, 开胸术后, 术后肺炎

Abstract: Objective: To study the clinical effect of the oxygen drive aerosol in halation with bude-sonide and ambroxol in the prevention of adult post-thoracotomy pneumonia. Methods: This was a randomized, open and parallel controlled trial. We chose 80 cases of patients in the department of thoracic surgery in the First Affiliated Hospital of Xi’an Jiaotong University which fitted our criteria as the research object. The  selected patients were randomly divided into the active group and the control group, and the active group underwent oxygen drive aerosol inhalation (2 mg budesonide combined 60 mg am-broxol) for 3 days before operation, and the control group without preoperative aerosol inhalation, and their postoperative therapy was the same. Results: The baseline data showed that the differences in sex, age, disease and smoking were not statistically significant between the two groups, P>0.05. The results of blood gas analysis before 12 hours of operation suggested that, the PaO2 and PaCO2 values of the active group were (88.40±9.40) mmHg and (38.30±6.10) mmHg; The PaO2 and PaCO2 values of the control group were (85.09±7.18) mmHg and (41.21±3.15) mmHg. And the two groups’ P values were 0.029 and 0.011, with statistical differences. There were 3 patients who developed postoperative pneumonia out of 40 patients in the active group, the incidence was 7.50%, but the incidence of control group was 25.00%. The P value was 0.034, with statistical differences. We also analyzed the influence of different diseases and surgical methods on postoperative pneumonia, and the results showed that in the active group and the control group, the incidence of postoperative pneumonia in the patients with esophageal cancer was lower than that in lung cancer patients, and there was a statistically significant difference (P<0.05). In the active group, the numbers of pulmonary deed resection, lobectomy and pulmonary sleeve resection were 2, 21 and 1 cases respectively, and the corresponding numbers in the control group were 2, 21 and 2. Among the two groups, the incidence of postoperative pneumonia in the patients with different surgical methods of lung cancer was statistically significant (P<0.05). Conclusion: If we implement respiratory preparation with budesonide plus ambroxol inhalation for 3 days before operation, we can greatly reduce the incidence of postoperative pneumonia.

Key words: Budesonide, Ambroxol, Aerosol inhalation, Post-thoracotomy, Pneumonia

中图分类号: 

  • R563.1
[1] 倪莲芳,王鹤,李虹,张志刚,刘新民. 非人类免疫缺陷病毒感染肺隐球菌病34例临床分析[J]. 北京大学学报(医学版), 2018, 50(5): 855-860.
[2] 王芳芳,杨殷杰,侯晓玫. 电火花蚀刻镍钛根管锉HyFlex EDM的表面形态和抗疲劳折断性能[J]. 北京大学学报(医学版), 2018, 50(5): 876-881.
[3] 王昊,陈亮,叶小云. 雷公藤甲素对TM4细胞氧化应激及PI3K/AKT通路的影响[J]. 北京大学学报(医学版), 2018, 50(4): 607-612.
[4] 王建伟,满立波,黄广林,王海,徐啸,朱晓斐,李玮,刘振华. 经会阴三步法手术策略治疗单纯性男性骨盆骨折后尿道离断[J]. 北京大学学报(医学版), 2018, 50(4): 617-620.
[5] 唐兴国,颜野,邱敏,卢剑,陆敏,侯小飞,黄毅,马潞林. 单中心16年青年膀胱尿路上皮癌患者的诊治[J]. 北京大学学报(医学版), 2018, 50(4): 630-633.
[6] 吴恺,张杨,张红,檀增桓,郭晓蕙,杨建梅. 嗜铬细胞瘤/副神经节瘤患者RET、VHL、SDHD、SDHB遗传基因变异的检测[J]. 北京大学学报(医学版), 2018, 50(4): 634-639.
[7] 吴鹏辉,谢瑶,赵卫红,华瑛,孙青,李硕,吴晔,卢新天. 血液病/肿瘤患儿并发可逆性后部白质脑病综合征[J]. 北京大学学报(医学版), 2018, 50(4): 662-665.
[8] 徐奔,张喆楠,罗程,宋海峰,张骞. 后腹腔镜下肿瘤吸除术与肾部分切除术治疗肾血管平滑肌脂肪瘤的安全性与有效性对比[J]. 北京大学学报(医学版), 2018, 50(4): 700-704.
[9] 郝一昌,侯小飞,赵磊,肖春雷,刘茁,张帆,马潞林. 全腹腔镜移植输尿管膀胱再植术处理肾移植术后输尿管狭窄[J]. 北京大学学报(医学版), 2018, 50(4): 705-710.
[10] 覃子健,毕海,马潞林,黄毅,张帆. 肠代膀胱内原发肠源性腺癌1例[J]. 北京大学学报(医学版), 2018, 50(4): 737-739.
[11] 张慧峰,黄焕焕,赵雨佳,李清如,祁宇泽,周辉. 苯并[a]芘对神经胶质细胞中胰岛素降解酶与脑啡肽酶表达的影响[J]. 北京大学学报(医学版), 2018, 50(3): 401-407.
[12] 林鸿波,陈奕,沈鹏,李小勇,司亚琴,张杜丹,唐迅,高培. 社区糖尿病患者慢性肾脏病的发病率及其危险因素[J]. 北京大学学报(医学版), 2018, 50(3): 416-421.
[13] 张艺潇,冯文. 决策树在贫困农村老人就诊影响因素中的应用[J]. 北京大学学报(医学版), 2018, 50(3): 450-456.
[14] 孙颖,靳蕾. 中国北方3县妊娠妇女血液锰浓度及其影响因素[J]. 北京大学学报(医学版), 2018, 50(3): 463-468.
[15] 何海珍,张婷,周景,王东平,王浩杰,宋阳,朱珠,王培玉,刘爱萍. 乌海市成人含糖饮料饮用与糖尿病的关系[J]. 北京大学学报(医学版), 2018, 50(3): 469-473.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 刘津, 王玉凤. 父母培训对共患对立违抗性障碍的注意缺陷多动障碍的作用[J]. 北京大学学报(医学版), 2007, 39(3): 310 -314 .
[2] 黄萍, 刘炯, 夏英杰, 仲燕莹, 陈跃国. 两种准分子激光手术治疗超高度近视的对比研究[J]. 北京大学学报(医学版), 2007, 39(5): 498 -502 .
[3] 刘朝晖, 吴文湘, 廖秦平. 体外培养人阴道上皮细胞感染假性酵母菌后肿瘤坏死因子-α的表达改变[J]. 北京大学学报(医学版), 2007, 39(5): 539 -541 .
[4] . 香港大学胡应湘夫人中华人民共和国学者奖学金[J]. 北京大学学报(医学版), 2001, 33(2): 177 .
[5] 黄宏思, 郝洁, 谢蜀生. 抗Ia单克隆抗体促进异基因皮肤移植耐受[J]. 北京大学学报(医学版), 2000, 32(4): 340 -342 .
[6] 金永柱, 谢蜀生. CTLA-4-FasL双功能分子的构建及其体外免疫抑制作用的研究[J]. 北京大学学报(医学版), 2001, 33(6): 485 .
[7] 林伟, 杨铭. 以TAR RNA 为靶的HIV-1抑制剂的研究进展[J]. 北京大学学报(医学版), 2002, 34(4): 384 -388 .
[8] 肖瑞平, 郑铭. β肾上腺素受体信号与心力衰竭[J]. 北京大学学报(医学版), 2002, 34(5): 464 -470 .
[9] 杜军保, 齐建光, 石云, 魏冰, 宫丽敏, 田宏, 石琳, 郭志良, 李万镇, 马郁文, 唐朝枢. 肺动脉高压形成机制中的气体信号分子网络[J]. 北京大学学报(医学版), 2002, 34(5): 536 -541 .
[10] 姜劲迈, 路桂荣, 宁涛, 柯杨. 胃癌细胞系Lewis抗原表达和体外诱发免疫应答反应[J]. 北京大学学报(医学版), 2002, 34(6): 669 -671 .