盐酸氨溴索注射液对重型颅脑损伤患者肺保护的临床研究

Study of effect of ambroxol hydrochloride on lung protection of severe traumatic brain patients

目的分析盐酸氨溴索注射液对重型颅脑损伤患者肺功能保护的临床作用。方法将入住该院ICU内的重型颅脑损伤患者50例随机分为治疗组及对照组,对照组采用经典的颅脑损伤治疗方案,治疗组在经典治疗的基础上加用盐酸氨溴索注射液(沐舒坦针)30 mg+100 mL生理盐水静脉注射,每日3次。观察患者的临床症状、体征及实验室检查结果。采用GCS评分评价患者治疗后的神志情况;肺部情况连续观察7 d,记录患者的肺部感染发生率、肺不张发生率、急性呼吸窘迫综合征(ARDS)发生率及肺损伤评分(LIS);并记录患者住ICU时间、总住院时间及28 d死亡率。结果连续观察7 d,治疗组肺部感染、肺不张及ARDS发生率明显低于对照组(P<0.05)。与对照组比较,治疗组第7天的肺损伤评分明显低于对照组(P<0.05)。治疗组的ICU住院时间、总住院时间及28 d死亡率明显低于对照组(P<0.05)。结论盐酸氨溴索注射液能一定程度上预防重型颅脑损伤患者的肺部并发症,减少住院时间,降低病死率,提高重型颅脑损伤患者的疗效。

Objective To analyse the effect of ambroxol hydrochloride on lung function in the patients with severe traumatic brain injury.Methods 50 patients with severe brain injury admitted to ICU were randomly divided into the treatment group and the control group,the control group using the classical treatment of brain injury,treatment group adding ambroxol hydrochloride injection on the basis of the classical treatment.Clinical symptoms,signs and laboratory findings were observed,and the GCS was evaluated.Results After 7 d continuous observation,pulmonary infection,atelectasis and ARDS of the treatment group was significantly lower than the control group（P〈0.05）.Compared with the control group,lung injury score of the treatment group on 7 d were significantly lower than those of the control one（P〈0.05）,and also ICU length of stay in treatment group,total hospital stay and 28 d mortality were significantly lower than those in the control group（P〈0.05）.Conclusion Using ambroxol hydrochloride for the patients with severe traumatic brain injury can prevent the lungs of complications,reduce hospitalization time,mortality and improve the treatment effect of severe head injury.