大剂量泵注盐酸氨溴索对呼吸机相关性肺炎患者感染控制及预后的影响

Effects of Pumping High-dose Ambroxol Hydrochloride on the Infection Control and Prognosis of Patients with Ventilator-associated Pneumonia

目的:观察大剂量泵注盐酸氨溴索对呼吸机相关性肺炎患者感染控制及预后的影响。方法:80例呼吸机相关性肺炎患者随机分为对照组(41例)和观察组(39例)。两组患者均给予吸氧、雾化、营养支持、维持机体稳态平衡等常规对症治疗,同时根据细菌培养结果进行抗菌治疗。在此基础上,对照组患者给予注射用盐酸氨溴索30 mg,静脉滴注,tid;观察组患者给予注射用盐酸氨溴索300 mg,静脉泵注,6 h内完成,qd。两组疗程均为2周。观察两组患者临床疗效,记录肺部感染(CPIS)评分、氧合指数、白细胞介素(IL)-6水平、急诊住院时间、机械通气时间及治疗期间不良反应发生情况。结果:观察组患者痊愈率、有效率显著高于对照组,急诊住院时间、机械通气时间显著短于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者CPIS评分、IL-6水平显著低于同组治疗前,且观察组低于对照组;氧合指数显著高于同组治疗前,且观察组高于对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:大剂量泵注盐酸氨溴索治疗呼吸机相关性肺炎疗效好于常规剂量静脉滴注,可以加大对患者的感染控制力度,改善预后,且不增加不良反应的发生。

OBJECTIVE： To observe the effects of pumping different dose ambroxol hydrochloride on the infection control and prognosis of patients with ventilator-associated pneumonia. METHODS： 80 patients with ventilator-associated pneumonia were ran- domly divided into control group （41 cases） and observation group （39 cases）. All patients received conventional symptomatic treat- ment, including oxygen inhalation, atomization, nutritional support, maintaining steady state equilibrium and effective antibiotics based on the bacterial culture results. Based on it, control group was given ambroxol hydrochloride 30 mg, intravenously infused, tid; observation group was given ambroxol hydrochloride 300 mg, intravenously pumped within 6 h, qd. All patients were treated for 2 weeks. Clinical efficacy in 2 groups was observed, pulmonary infection score （CPIS）, oxygenation index, IL-6 level, ICU hospitalization time, mechanical ventilation time and the incidence of adverse reactions in 2 groups were recorded. RESULTS： The cure rate in observation group was significantly higher than control group, hospitalization time and mechanical ventilation time were significantly shorten than control group, with statistical significance （P〈0.05）. After treatment, CPIS, IL-6 scores in 2 groups were significantly lower than before, and observation group was lower than control group; oxygenation index was signifi- cantly higher than before, and observation group was higher than control group, with statistical significance （P〈0.05）. And there was no significant difference in the incidence of adverse reactions between 2 groups （P〉0.05）. CONCLUSIONS： Pumping high-dose ambroxol hydrochloride has better efficacy than intravenous infusion of conventional dose in the treatment of ventilator-as- sociated pneumonia than conventional dose, it can increase the control efforts for injection, improve prognosis, and does not in- crease the incidence of adverse reactions.