围手术期应用氨溴索对原发性肺癌患者微创手术效果的影响

Clinical Effect of Short-term Perioperative Treatment with Ambroxol after Thorocoscopic Pulmonary Lobectomy for Primary Lung Cancer Patients

目的探讨围术期静脉给予大剂量盐酸氨溴索注射液对胸腔镜下肺叶切除术后肺癌患者的影响。方法选取2012年4月到2014年5月期间我院收治的110例行胸腔镜下肺叶切除术患者,随机分为实验组与对照组,每组55例。实验组于手术结束后当天直至术后3 d给予盐酸氨溴索静脉滴注;对照组在同样的时间段给予等量生理盐水。记录并比较两组患者的术中指标、手术前后的肺功能、手术后并发症、机械通气时间、入住ICU时间、术后住院时间。结果两组患者的FVC%、FEV1%较术前均有所下降,对照组患者下降的幅度大于实验组,有统计学差异(P<0.05);术后48 h实验组患者的SPA、PAF水平均低于对照组患者,差异有统计学意义(P<0.05);术后肺部感染率、机械通气时间、ICU入住时间、术后住院时间等方面实验组患者明显少于对照组患者,有统计学差异(P<0.05)。结论盐酸氨溴索能够改善胸腔镜下肺叶切除术患者的肺功能,降低术后肺部感染的可能性,减少机械通气、入住ICU及术后住院时间,值得在临床上进一步研究和应用。

Objective To assess in a randomized clinical trial the influence of perioperative short-term ambroxol administration on postoperative complications,hospital stay and respiratory functions after thorocoscopic pulmonary lobectomy for lung cancer patients. Methods 110 consecutive patients undergoing lobectomy for lung cancer（ April 2012-May 2014） were randomized in two groups. Group A（ 55 patients） ： ambroxol was administered by intravenous infusion in the context of the usual therapy on the day of operation and on the first3 postoperative days. Group B（ 55 patients） ： fluid therapy only without ambroxol. Groups were compared in terms of occurrence of postoperative complications,length of stay and respiratory functions. Results The reduction of FVC%,FEV1% in group A was less than that of group B（ P〈0. 05）. And the plasma SPA and PAF of group A was lower than group B（ P〈0. 05）. Compared to group B,group A（ ambroxol） had a reduction of postoperative pulmonary complications（ P〈0. 05）,and shorter unplanned ICU admission / hospital stay（ P〈0. 05）. Conclusion Short-term perioperative treatment with ambroxol can improve the early outcomes after thorocoscopic pulmonary lobectomy for lung cancer patients.