氨溴索雾化吸入联合无创正压通气治疗急性呼吸衰竭患者临床疗效及对肺功能、呼吸动力学的影响

Clinical Efficacy of Ambroxol Aerosol Inhalation Combined with Non-Invasive Positive Pressure Ventilation in the Treatment of Acute Respiratory Failure Patients and Its Effects on Lung Function and Respiratory Dynamics

目的分析氨溴索雾化吸入联合无创正压通气(NPPV)在急性呼吸衰竭(ARF)患者中的应用效果。方法选取江苏省如皋市中医院2020年4月至2022年10月收治的92例ARF患者,按随机数字表法分为2组,各46例,对照组采取NPPV治疗,观察组在对照组基础上另加用氨溴索雾化吸入,对比2组临床效果及治疗前、治疗7 d后呼吸动力学、肺功能、动脉血气指标变化,并比较2组ICU入住时间、住院时间、6个月内死亡率、不良反应发生率。结果观察组总有效率95.65%(44/46),较对照组78.26%(36/46)高(P<0.05)。治疗7 d,观察组呼吸频率(RR)、平均气道压(Pm)及气道阻力(Raw)较对照组低,第1 s用力呼气容积(FEV_(1))、最大通气量(MVV)及用力肺活量(FVC)较对照组高(P<0.05)。治疗7 d,观察组动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))较对照组优(P<0.05)。观察组ICU入住时间、住院时间均短于对照组(P<0.05),6个月死亡率较对照组低(P<0.05)。观察组患者腹痛、恶心呕吐各1例,对照组患者腹痛1例,恶心呕吐、皮肤瘙痒各2例,2组不良反应发生率比较差异无统计学意义(χ^(2)值=0.618,P值=0.432)。结论对ARF患者采取NPPV联合氨溴索雾化吸入治疗,可显著改善患者肺功能和呼吸动力学,提高临床疗效,加快患者病情好转。

Objective To analyze the clinical efficacy of combining ambroxol aerosol inhalation with non-invasive positive pressure ventilation(NPPV)in the treatment of acute respiratory failure(ARF).Methods A total of 92 ARF patients admitted to Rugao Hospital of Traditional Chinese Medicine from April 2020 to October 2022 were randomly divided into two groups:the control group(n=46)received NPPV alone,while the observation group(n=46)received ambroxol aerosol inhalation in addition to NPPV.Clinical efficacy,changes in respiratory dynamics,lung function,arterial blood gas parameters before and after 7 days of treatment,as well as ICU stay,hospital stay,6-month mortality,and adverse reaction rates were compared between the two groups.Results The total effective rate in the observation group was 95.65%(44/46),significantly higher than 78.26%(36/46)in the control group(P<0.05).After 7 days of treatment,the observation group showed significantly lower respiratory rate(RR),mean airway pressure(Pm),and airway resistance(Raw),and significantly higher forced expiratory volume in 1 second(FEV_(1)),maximum voluntary ventilation(MVV),and forced vital capacity(FVC)compared to the control group(P<0.05).Additionally,the observation group exhibited superior arterial blood gas parameters,including partial pressure of oxygen(PaO_(2)),oxygen saturation(SaO_(2)),and partial pressure of carbon dioxide(PaCO_(2)),compared to the control group(P<0.05).The observation group also had shorter ICU and hospital stays,and a lower 6-month mortality rate compared to the control group(P<0.05).Adverse reactions were minimal in both groups,with no significant difference in the incidence of adverse events(χ^(2)=0.618,P=0.432).Conclusion NPPV combined with ambroxol aerosol inhalation significantly improves lung function and respiratory dynamics,accelerates recovery,and enhances clinical outcomes in ARF patients.