盐酸氨溴索配合支气管镜肺泡灌洗治疗对重症肺炎伴肺不张患者症状改善时间、炎症反应的影响

Effect of Ambroxol Hydrochloride Combined with Bronchoscopic Alveolar Lavage on the Improvement Time of Symptoms and Inflammatory Response in Patients with Severe Pneumonia and Atelectasis

目的探讨盐酸氨溴索配合支气管镜肺泡灌洗在重症肺炎伴肺不张患者中的应用效果。方法选取2023年1—9月我院收治的60例重症肺炎伴肺不张患者为研究对象,按随机数字表法将其分为对照组与观察组,各30例。对照组采用支气管镜肺泡灌洗治疗,观察组在此基础上加用盐酸氨溴索治疗,持续治疗2周。比较两组的炎症反应、症状改善时间、肺功能指标、血气指标差异。结果治疗后,观察组白细胞介素-6、C反应蛋白、降钙素原水平分别为(47.36±4.33)pg/mL、(7.35±1.02)mg/L、(0.45±0.11)μg/L,均低于对照组的(52.43±4.96)pg/mL、(9.46±1.13)mg/L、(0.71±0.13)μg/L,组间差异有统计学意义(P<0.05);观察组体温、肺不张、咳嗽及肺湿啰音改善时间分别为(1.89±0.22)d、(7.52±1.12)d、(3.15±0.34)d、(4.05±0.49)d,均短于对照组的(2.45±0.36)d、(9.63±1.25)d、(4.25±0.47)d、(5.14±1.02)d,组间差异有统计学意义(P<0.05);观察组用力肺活量(FVC)、第1秒用力呼气容积(FEV;1;)、FEV;1;/FVC分别为(3.25±0.39)L、(2.46±0.35)L、(75.69±5.82)%,均大于对照组的(2.89±0.35)L、(2.04±0.32)L、(70.59±5.73)%,组间差异有统计学意义(P<0.05);观察组氧分压为(90.63±6.34)mmHg(1 mmHg=0.133 kPa),高于对照组的(84.57±6.22)mmHg,二氧化碳分压为(38.47±3.43)mmHg,低于对照组的(42.46±4.02)mmHg,组间差异有统计学意义(P<0.05)。结论盐酸氨溴索联合支气管镜肺泡灌洗可加快重症肺炎伴肺不张患者的炎症消退,减轻肺功能障碍,纠正血气异常,促进疾病症状消失。

Objective To explore the application effect of ambroxol hydrochloride combined with bronchoscopic alveolar lavage in patients with severe pneumonia and atelectasis.Methods 60 patients with severe pneumonia and atelectasis admitted to our hospital from January 2023 to September 2023 were selected as the research objects,and were divided into a control group and an observation group according to the random number table method,with 30 cases in each group.The control group was treated with bronchoscopic alveolar lavage,and the observation group was treated with ambroxol hydrochloride on this basis for two weeks.The inflammatory response,symptom improvement time,lung function index and blood gas index were compared between the two groups.Results After treatment,the levels of Interleukin-6,C-reactive protein,procalcitonin levels in the observation group were(47.36±4.33)pg/mL,(7.35±1.02)mg/L,(0.45±0.11)μg/L,respectively.The levels were lower than(52.43±4.96)pg/mL,(9.46±1.13)mg/L,(0.71±0.13)μg/L of the control group,the differences between the two groups were statistically significant(P<0.05).The improvement time of body temperature,atelectasis,cough and lung moist rales in the observation group were(1.89±0.22)d,(7.52±1.12)d,(3.15±0.34)d and(4.05±0.49)d,respectively,which were shorter than(2.45±0.36)d,(9.63±1.25)d,(4.25±0.47)d,(5.14±1.02)d in the control group.The differences between the two groups were statistically significant(P<0.05).forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),FEV1/FVC in the observation group were(3.25±0.39)L,(2.46±0.35)L,(75.69±5.82)%,respectively,which were greater than(2.89±0.35)L,(2.04±0.32)L,(70.59±5.73)%in the control group.The difference between the two groups were statistically significant(P<0.05).The oxygen partial pressure of the observation group was(90.63±6.34)mmHg(1 mmHg=0.133 kPa),which was higher than(84.57±6.22)mmHg of the control group,and the partial pressure of carbon dioxide was(38.47±3.43)mmHg,which was lower than(42.46±4.02)mmHg of the control group,the differences between the two groups were statistically significant(P<0.05).Conclusion Ambroxol hydrochloride combined with bronchoscopic alveolar lavage can accelerate the resolution of inflammation in patients with severe pneumonia and atelectasis,reduce pulmonary dysfunction,correct abnormal blood gas,and promote the disappearance of disease symptoms.