复方异丙托溴铵术前雾化预防老年急腹症肺部并发症的临床研究

Clinical Study of Compound Ipratropium Bromide Preoperative Inhalation for Preventing Pulmonary Complications in Elderly Patients with Acute Abdominal Diseases

目的:探讨复方异丙托溴铵术前雾化预防老年急腹症肺部并发症的临床意义。方法:将2014年6月-2014年12月在全麻气管插管下手术治疗的急腹症老年患者60例随机分为A组和C组各30例,A组术前行复方异丙托溴铵雾化吸入,C组按常规处理,比较两组气管插管前(T1)、气管插管后(T2)、气管拔管前(T4)、气管拔管后(T5)的平均动脉压(MAP)、心率(HR)、拔管后不良反应;比较雾化前(T0)、雾化后(T3)120 min中心静脉血中IL-6、IL-8、IL-10水平;术后1 h评价咽部舒适感,术后72 h内记录肺部并发症情况。结果:与C组比较,A组患者产生的不良反应少,血清IL-6、IL-8、IL-10水平低,肺部感染发生率降低(P<0.05)。结论:复方异丙托溴铵术前雾化可预防老年急腹症患者围术期肺部并发症。

Objective： To explore the clinical significance of compound ipratropium bromide preoperative inhalation for preventing the pulmonary complications in elderly patients with acute abdominal diseases. Methods： 60 elderly patients with acute abdominal diseases treated by operation by endotracheal intubation under general anesthesia were randomly divided into group A （n=30） and group C （n=30） from Jun 2014 to Dec 2014.Group A preoperative was inhaled compound ipratropium bromide on the basic treatment of group C. Before tracheal intubation （T1）, after tracheal intubation （T2）, before tracheal extubation （T4） and after tracheal extubation （T5）, the mean arterial pressure （MAP）, heart rate （HR） and adverse reaction were compared. The blood of the central vein were extracted before inhalation （T0） and 120 min after inhalation （T3） to compare the IL-6, IL-8 and IL-10 levels. The patients assess throat comfort 1 h after operation and postoperative pulmonary complications of 72h after operation were recorded. Results： Compared to group C,adverse reactions were significantly less,the levels of serum IL-6, IL-8 and IL-10 decreased and the incidence of pulmonary infection reduced in group A （all P＆lt;0.05）. Conclusions：Preoperative compound ipratropium bromide inhalation in elderly patients with acute abdominal diseases can prevent perioperative pulmonary complications.