机械通气联合盐酸氨溴索对老年急性呼吸窘迫综合征患者氧合指标和炎性因子的影响

Effect of mechanical ventilation combined with ambroxol hydrochloride for oxygenation index and inflammatory factor in elderly patients with acute respiratory distress syndrome

目的探讨机械通气与盐酸氨溴索联合治疗老年急性呼吸窘迫综合征(ARDS)的临床疗效。方法将2013年2月至2014年2月该院就诊的52例老年ARDS患者随机分为实验组和对照组,两组均采用抗炎、营养、脱水和吸痰等支持治疗,对照组仅采用机械通气治疗,实验组采用机械通气与盐酸氨溴索联合治疗。对比两组治疗前及治疗后1 w体内氧合指标及炎性因子浓度。结果两组患者经1 w治疗后,与治疗前相比,血清白细胞介素(IL)-10浓度、动脉血氧饱和度(Sa O2)、脉血氧分压(Pa O2)、氧合指数(Pa O2/Fi O2)均上升,血清IL-6和肿瘤坏死因子(TNF)-α浓度均降低(均P<0.05);且实验组以上各指标较对照组改善更明显(均P<0.05)。结论机械通气与盐酸氨溴索联合治疗ARDS可改善患者体内的氧合指标,调节细胞因子水平,增强患者抗炎能力,提高疗效。

Objective To investigate the clinical efficacy of mechanical ventilation combined with ambroxol hydrochloride in the treatment of elderly patients with acute respiratory distress syndrome( ARDS). Methods 52 elderly patients with ARDS were randomly divided into experiment and control groups,all patients were given anti-inflammatory,nutrition,dehydration and sputum suction and other supportive treatment. The control group was only treated by mechanical ventilation,while the experiment group was treated by mechanical ventilation combined with ambroxol hydrochloride. The body oxygenation index and inflammatory factor concentration were compared between two groups before and after 1 w treatment. Results After 1 w treatment,the serum levels of IL-10,Sa O2,Pa O2,Pa O2/ Fi O2 in two groups were increased,while the concentrations of serum IL-6 and TNF-α were decreased comparing with those before treatment( P<0. 05); and the parameters mentioned above in experimental group were improved more obviously than those of control group( P<0. 05). Conclusions Mechanical ventilation combined with ambroxol hydrochloride is a good way to treat the elderly patients with ARDS with the advantages of improving oxygenation index,regulating cytokine levels,enhancing the anti-inflammatory ability and improving the curative effect.