大剂量氨溴索联合呼吸机对老年重症肺炎患者症状改善及炎症指标的影响

Effects of high-dose ambroxol combined with ventilator on symptom improvement and inflammation indexes in elderly patients with severe pneumonia

目的探究大剂量氨溴索联合呼吸机对老年重症肺炎患者症状改善及炎症指标的影响。方法回顾性分析,收集2018年11月—2020年3月信阳市第一人民医院收治的实施常规剂量氨溴索联合呼吸机治疗方案的40例老年重症肺炎患者临床资料纳入对照组;收集同期收治的实施大剂量氨溴索联合呼吸机治疗方案的40例老年重症肺炎患者临床资料纳入观察组,两组均治疗2周。比较两组治疗期间临床指标、治疗前及治疗2周后炎症因子水平及血气指标以及治疗期间不良反应发生情况。结果观察组症状改善时间、机械通气时间短于对照组,病灶吸收率高于对照组(P<0.05);治疗前,两组降钙素原(PCT)、C-反应蛋白(CRP)、动脉氧气分压(PaO;)、氧合指数对比,差异无统计学意义(P>0.05);治疗2周后,两组PCT、CRP均较治疗前降低,PaO;、氧合指数较治疗前升高,且观察组变化更大(P<0.05);治疗期间,两组均未出现明显不良反应,差异无统计学意义(P>0.05)。结论在老年重症肺炎患者中实施大剂量氨溴索联合呼吸机治疗方案,能有效改善患者临床症状,缩短机械通气时间、提升病灶吸收率,也能有效减轻机体炎症反应,改善患者血气指标,促进患者早日恢复健康。

Objective To explore the effects of high-dose Ambroxol combined with ventilator on symptom improvement and inflammation indexes in elderly patients with severe pneumonia.Methods The clinical data of 40 elderly patients with severe pneumonia treated with conventional ambroxol combined with ventilator in Xinyang the First People’s Hospital from November 2018 to March 2020 were retrospectively analyzed and included in the control group.The clinical data of 40 elderly patients with severe pneumonia treated with high-dose Ambroxol combined with ventilator during the same period were collected and included in the observation group.Both groups were treated for 2 weeks.The clinical indexes,inflammatory factors and blood gas indexes before and 2 weeks after treatment,and the occurrence of adverse reactions during treatment were compared between the two groups.Results The time for symptom improvement and mechanical ventilation in the observation group were shorter than that in the control group,and the rate of lesion absorption was higher than that in the control group(P<0.05).Before treatment,there was no significant difference in PCT,CRP,PaO;,oxygenation index between the two groups(P>0.05).After 2 weeks of treatment,PCT and CRP in both groups were lower than before treatment,PaO;and oxygenation index were higher than before treatment,and the change in the observation group was greater(P<0.05).During the treatment period,no obvious adverse reactions occurred in the two groups,and the difference was not statistically significant(P>0.05).Conclusion In elderly patients with severe pneumonia,the implementation of high-dose Ambroxol combined with ventilator treatment can effectively improve the clinical symptoms,shorten the time of mechanical ventilation,improve the absorption rate of lesions,effectively reduce the inflammatory reaction,improve the blood gas index of patients,and promote the early recovery of patients.