布地奈德联合氨溴索超声雾化吸入对合并COPD的剖胸术患者围术期肺功能的保护作用

Protective Effects of Ultrasonic Aerosol Inhalation of Budesonide Combined with Ambroxol on Pulmonary Function of COPD Patients Underwent Thoracotomy during Perioperative Period

目的：观察布地奈德联合氨溴索超声雾化吸入对合并慢性阻塞性肺疾病（COPD）的剖胸术患者围术期肺功能的保护作用。方法：选择合并COPD的剖胸术患者87例作为治疗组,另选同一时期接受剖胸术、不合并COPD的患者256例作为对照组。治疗组患者围术期给予布地奈德2 mg＋氨溴索30 mg,加入20 ml灭菌注射用水中,用超声雾化吸入器雾化吸入,4次/d。观察治疗组患者在入院时和术前的动脉血气和肺功能;比较两组患者的呼吸衰竭发生率和死亡率。结果：治疗组患者治疗第5日和治疗第8~10日的氧分压和第一秒用力呼气量占预计值的百分比显著高于入院时,二氧化碳分压显著低于入院时,差异有统计学意义（P〈0.05）;两组患者呼吸衰竭发生率和死亡率比较,差异无统计学意义（P〉0.05）。结论：布地奈德联合氨溴索超声雾化吸入,用于合并COPD的胸科疾病患者的围术期治疗,能明显改善患者呼吸功能,提高手术耐受性。

OBJECTIVE：To observe protective effects of ultrasonic aerosol inhalation of budesonide combined with ambroxol on pulmonary function of COPD patients underwent thoracotomy during perioperative period.METHODS：87 COPD patients with thoracic disease admitted in our hospital as treatment group.with 256 patients without COPD underwent thoracotomy as control group.Treatment group were given ultrasonic aerosol inhalation of budesonide 2 mg combined with ambroxol 30 mg in 20 ml sterilized water for injection during perioperative period,4 times daily.Pulmonary function and artery blood gas of treatment group were observed once hospitalized and before operation.The incidence of respiratory failure and mortality were compared between 2 groups.RESULTS：Compared with on admission,pbt（O2）and FEV1/predicted value（%）of treatment group were increased significantly 5 days after treatment and on 8th-10th day after treatment;pbt（CO2）was significantly lower than on admission,there was statistical significance（P0.05）.There was no statistical significance in the incidence of respiratory failure and mortality rate between 2 groups（P0.05）.CONCLUSIONS：Perioperative application of ultrasonic aerosol inhalation of budesonide and ambroxol can effectively improve respiratory function and tolerance for thoracotomy in COPD patients underwent thoracotomy.