大剂量氨溴索治疗肺癌患者医院感染的临床研究

Clinical effect of high-dose ambroxol on treatment of nosocomial infections in lung cancer patients

目的研究大剂量氨溴索治疗肺癌患者医院感染的效果与安全性,为提高临床肺癌患者医院感染的诊治水平提供参考。方法选择医院2011年1月-2013年3月合并医院感染的肺癌患者56例随机分为两组,常规剂量组28例患者给予常规抗感染药物并结合小剂量氨溴索治疗,研究组28例患者给予常规抗感染药物并结合大剂量氨溴索治疗,同时选择28例常规抗感染药物治疗的患者作为对照组,1周后对治疗效果进行评价,记录本研究药物相关的不良反应,同时比较两组治疗前、后血气分析指标。结果治疗后3组血气指标PaO2、SaO2、PaO2/Fio2均较治疗前明显提高,治疗后血气指标与治疗前比较差异有统计学意义(P<0.05);研究组治疗后血气指标提高幅度明显大于对照组与常规剂量组,研究组痊愈6例、显效9例、有效10例,总有效率达89.29%;而常规剂量组与对照组总有效率分别为75.00%、60.71%;研究组治疗效果明显好于其他两组,组间比较差异有统计学意义(P<0.05);未发现明显与研究药物有关的不良反应病例。结论大剂量氨溴索有助于感染的治疗,其功效在于有效化痰,提高抗菌药物治疗的血药浓度,从而使治疗效果最大化。

OBJECTIVE To study the effect and safety of high-dose ambroxol on treatment of nosocomial infections in lung cancer patients so as to improve the level of diagnosis and treatment of nosocomial infections in the lung cancer patients.METHODS A total of 56lung cancer patients complicated with nosocomial infections who were treated in the hospital from Jan 2011to Mar 2013were randomly divided into two groups,then the standard-dose group with 28cases was treated with traditional antibiotics combined with low-dose ambroxol,the study group with 28cases was given the traditional antibiotics combined with high-dose ambroxol,meanwhile,28patients who were treated with traditional antibiotics were assigned as the control group,the therapeutic effect was observed one week after the treatment,the antibiotic-induced adverse reactions were recorded,and the indicators for blood gas analysis were compared between the two groups before and after the treatment.RESULTS Three weeks after the treatment,the blood gas indicators such as PaO2,SaO2,and PaO2/Fio2 were significantly elevated as compared with those before the treatment,the difference in the blood gas indicators between before and after the treatment was significant（P＆lt;0.05）.The increase of the blood gas indicators was significantly greater in the study group than in the control group as well as in the standard-dose group.Totally 6cases in the study group were cured,9cases improved,10cases effective,and the total effective rate reached up to 89.29%,75.00%in the standard-dose group,60.71% in the control group.The therapeutic effect was significantly better in the study group than in other two groups,the difference was significant（P＆lt;0.05）.The adverse reactions that were obviously related to the antibiotics have not been found.CONCLUSIONThe high-dose ambroxol may contribute to the treatment of infections,with its effectiveness in expectorant or increase of the blood concentration,which therefore maximize the therapeutic effect.