盐酸氨溴索联合头孢哌酮钠舒巴坦钠治疗重症肺炎的临床效果

Clinical effect of ambroxol hydrochloride combined with cefoperazone sodium and sulbactam sodium in the treatment of severe pneumonia

目的观察盐酸氨溴索联合头孢哌酮钠舒巴坦钠治疗重症肺炎的临床效果。方法选取2020年10月1日—2022年9月30日南平市人民医院收治的重症肺炎者110例,根据单双号法分为联用氨溴索组和单用治疗组,各55例。在常规治疗基础上,单用治疗组予注射用头孢哌酮钠舒巴坦钠治疗,联用氨溴索组在单用治疗组基础上联用盐酸氨溴索注射液治疗,2组均治疗10~14 d。比较2组患者治疗效果、症状(高热、咳嗽、肺部啰音)消失时间、住院时间,治疗前后炎性指标[降钙素原(PCT)、C反应蛋白(CRP)]、动脉血气指标[动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]及不良反应。结果联用氨溴索组患者治疗总有效率为98.18%,高于单用治疗组的85.45%(χ^(2)=5.930,P=0.015);联用氨溴索组高热、咳嗽与肺部啰音消失时间及住院时间均短于单用治疗组(P<0.01);治疗后,2组PCT、CRP水平和PaCO_(2)较治疗前下降,SaO_(2)、PaO_(2)较治疗前上升,且联用氨溴索组下降或上升的程度大于单用治疗组(P均<0.01);联用氨溴索组与单用治疗组不良反应总发生率(7.27%vs.9.09%)比较差异无统计学意义(χ^(2)=0.121,P=0.728)。结论盐酸氨溴索联合头孢哌酮钠舒巴坦钠治疗重症肺炎能提高治疗的效果,可缩短住院治疗时间,更好地降低炎性指标和改善血气指标,且不会增加不良反应发生率,安全有效。

Objective To observe the clinical effect of ambroxol hydrochloride combined with cefoperazone sodium and sulbactam sodium in the treatment of severe pneumonia.Methods A total of 110 patients with severe pneumonia admitted to Nanping People′s Hospital from October 1,2020 to September 30,2022 were selected and divided into ambroxol group and monotherapy group according to the single and even numbering method,with 55 cases in each group.On the basis of conventional treatment,the monotherapy group was treated with cefoparazone sodium and sulbactam sodium for injection,and the ambroxol group was treated with ambroxol hydrochloride injection on the basis of the monotherapy group.Two groups were treated for 10~14 days.The treatment effect,disappearance time of clinical symptoms(high fever,cough,pulmonary rales),hospitalization time,changes of inflammatory indexes(PCT,CRP),arterial blood gas indexes(SaO_(2),PaO_(2),PaCO_(2))before and after treatment,and adverse reactions of the two groups were compared.Results The total effective rate of the ambroxol group was 98.18%,higher than 85.45%of the monotherapy group(χ^(2)=5.930,P=0.015).The disappearance time of high fever,cough,pulmonary rales and hospitalization time in the ambroxol group were shorter than those in the monotherapy group(P<0.01).After treatment,the levels of PCT,CRP and PaCO_(2)in two groups decreased,SaO_(2)and PaO_(2)increased,and the degrees of decrease or increase in the ambroxol group were greater than those in the monotherapy group(P<0.01).There was no significant difference in the total incidence of adverse reactions between the ambroxol group and the monotherapy group(7.27%vs.9.09%,χ^(2)=0.121,P=0.728).Conclusion Ambroxol hydrochloride combined with cefoperazone sodium and sulbactam sodium in the treatment of severe pneumonia can improve the treatment effect,shorten the hospitalization time of patients,better reduce inflammatory indicators and improve blood gas indicators,and will not increase the incidence of adverse reactions,which is safe and effective.