氨溴索预防腰-硬联合麻醉下剖宫产产妇吸入性肺炎的临床效果分析

Small dose of ambroxol for preventing the aspiration pneumonia in post-caesarean women with combined spinal epidural anesthesia

目的探讨氨溴索(商品名:沐舒坦)预防腰-硬联合麻醉下剖宫产产妇发生吸入性肺炎的临床效果。方法将我院收治的腰-硬联合麻醉下剖宫产产妇103例,按入院顺序将其分为观察组(56例)及对照组(47例)。对照组仅给予腰-硬联合麻醉,观察组在上述基础上于术前给予沐舒坦进行预防治疗。比较两组术后吸入性肺炎发生情况以及生产前后两组产妇的各项临床指标。结果观察组共出现吸入性肺炎2例(3.57%),明显低于对照组的8例(17.02%),差异有统计学意义(P<0.05)。产后24 h,观察组的PaO_2、SaO_2水平明显高于对照组,PaCO_2明显低于对照组,且观察组WBC、NEUT、CRP、呼吸不畅改善时间、SaO_2恢复正常时间、机械通气时间以及住院时间均明显低于对照组,差异均有统计学意义(P<0.05)。结论剖宫产产妇在腰-硬联合麻醉前给予沐舒坦进行预防治疗,能够使产妇的血气指标以及相关炎性因子水平保持相对稳定,有效地预防了产后吸入性肺炎的发生,值得在临床上进行推广。

To investigate the clinical effects of small dose of ambroxol in preventing the aspiration pneumonia in post-caesarean women with combined spinal epidural anesthesia.One hundred and three post-caesarean women in our hospital were divided into observation group(n=56)and control group(n=47)according to admission order.The control group was only given the combined spinal epidural anesthesia while the observation group was given small dose ambroxol in the basis of the control group.After operation,the incidence of aspiration pneumonia and various clinical indexes were compared between the two groups.There were 2 cases of aspiration pneumonia in the observation group(3.57%)that were significantly lower than the control group(8 cases,17.02%)(P<0.05).After labor,the levels of PaO 2 and SaO2 were higher while PaCO 2 level was lower in the observation group than those in the control group.Moreover,WBC,NEUT,CRP,improvement time of difficult breath,time of SaO 2 recovery,time of mechanical ventilation and hospital stay in the observation group were all lower or shorter than those in the control group(P<0.05).Giving small doses of ambroxol to post-caesarean women with combined spinal epidural anesthesia can make the blood gas indexes and remain the relative stable maternal inflammatory factor levels and effectively prevent the occurrence of postpartum aspiration pneumonia.It is worthy of clinical promotion.