大剂量盐酸氨溴索注射液对肺癌患者术后肺功能恢复的效果

Effect of high dose ambroxol intravenous injection on postoperative lung function recovery in patients with lung cancer

目的观察使用大剂量盐酸氨溴索注射液在肺癌根治术围手术期对患者肺功能恢复的效果。方法选取2016年9月至2019年11月在东莞市人民医院进行肺癌手术的150例非小细胞肺癌患者,将其随机分为对照组和观察组,每组各75例,均采用胸腔镜肺癌根治手术,对照组于手术当天和术后5 d给予常规剂量(30 mg/d)盐酸氨溴索静脉滴注治疗,观察组采用大剂量(500 mg/d)盐酸氨溴索静脉滴注治疗。比较两组病人手术前后肺功能指标、血清炎症因子白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)和C-反应蛋白(CRP)的水平变化以及术后并发症的发生情况。结果观察组和对照组患者术后5 d的肺功能指标均显著低于术前1 d,差异有统计学意义(P<0.01)。观察组术后5 d肺活量25%时呼气流速(PEF25)明显高于对照组,差异有统计学意义(P<0.01)。相比术前,对照组和观察组患者术后1 d血清中IL-6、TNF-α和CRP因子水平显著升高,差异有统计学意义(P<0.01)。对照组术后5 d的IL-6、TNF-α和CRP水平显著升高,但低于术后1 d,差异有统计学意义(P<0.01)。观察组术后1 d和5 d的IL-6、TNF-α和CRP水平均显著低于对照组,差异有统计学意义(P<0.01)。观察组和对照组手术后的并发症与不良反应发生率比较,差异无统计学意义(P>0.05)。结论在肺癌胸腔镜根治术围术期对患者使用大剂量的盐酸氨溴索,不仅能够减少手术对患者肺部组织造成的损伤,还有助于患者肺呼吸功能的恢复,降低术后炎症因子水平。

Objective To observe the effect of high dose ambroxol hydrochloride intravenous injection in the perioperative period of radical lung cancer surgery on lung function recovery in patients.Methods A total of 150 patients with non-small cell lung cancer who underwent lung cancer surgery in Dongguan People's Hospital from September 2016 to November 2019 were selected and randomly divided into the control group and the observation group,with 75 cases in each group.All patients in the two groups were treated with radical lung cancer surgery by thoracoscopy.The control group was given the conventional dose(30 mg/d)of ambroxol intravenously on the day of surgery and at 5d after surgery,while the observation group was given high dose(500 mg/d)of ambroxol intravenously.The lung function indexes and the changes in the levels of serum inflammatory factors interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and C-reactive protein(CRP)were compared before and after surgery between the two groups,and the occurrence of postoperative complications was also compared between the two groups.Results The lung function indexes of patients in both the observation and control groups were significantly lower at 5 d after surgery than at 1d before surgery,with statistically significant differences(P<0.01).The PEF25 in the observation group was significantly higher than that in the control group at 5 d afte r surgery,with statistically significant difference(P<0.01).Compared with the preoperative period,the serum levels of IL-6,TNF-αand CRP factors were significantly higher in the control group and the observation group at 1 d after surger y,with statistically significant differences(P<0.01).The levels of IL-6,TNF-αand CRP in the control group were significantly higher at 5 d after surgery,but lower than those at 1 d after surgery,with statistically significant differences(P<0.01).The levels of IL-6,TNF-αand CRP in the observation group were significantly lower than those in the control group at 1 d and 5 d after surgery,with statistically significant differences(P<0.01).There were no statistically significant differences in the rate of complications and adverse reactions between the observation group and the control group after surgery (P > 0.05). Conclusion The use of high dose ambroxol hydrochloride in patients in the perioperative period of radical lung cancer surgery by thoracoscopy can not only alleviate the injury caused by the surgery to the lung tissues of patients, but also contributes to the patient's lung respiratory function recovery and reduce the levels of p ostoperative inflammatory factors.