间断声门下灌洗联合大剂量氨溴索注射液对ICU重症肺炎疗效的影响

Effect of Interrupted Subglottic Lavage Combined with High-dose Ambroxol Injection on Severe Pneumonia in ICU

目的:观察间断声门下灌洗联合大剂量氨溴索注射液对重症监护室(ICU)重症肺炎疗效的影响。方法:选择2022年5月—2024年5月吉安市中心人民医院收治的62例ICU重症肺炎患者按照随机数字表法分为对照组(31例)、研究组(31例)。对照组采用氨溴索治疗,研究组在对照组的基础上给予间断声门下灌洗治疗。对比两组的临床疗效,检测两组的血气分析及呼吸力学指标,记录两组不良反应发生情况。结果:治疗后,研究组的总有效率为93.55%,高于对照组的70.97%(P<0.05)。治疗后,两组的pH、PaO_(2)水平均高于治疗前(P<0.05),PaCO_(2)水平均低于治疗前(P<0.05);研究组的pH、PaO_(2)水平均高于对照组(P<0.05),PaCO_(2)水平低于对照组(P<0.05)。治疗前,两组平均气道阻力、呼出潮气量对比,差异均无统计学意义(P>0.05);治疗后,两组平均气道阻力均下降,且研究组低于对照组(P<0.05),两组呼出潮气量均升高,且研究组高于对照组(P<0.05)。两组的不良反应总发生率对比,差异无统计学意义(P>0.05)。结论:采用间断声门下灌洗联合大剂量氨溴索注射液治疗ICU重症肺炎的临床效果显著,并能有效改善患者的血气指标与肺通气,安全性较高。

Objective:To observe the effect of interrupted subglottic lavage combined with high-dose Ambroxol Injection on severe pneumonia in intensive care unit(ICU).Method:A total of 62 ICU patients with severe pneumonia admitted to Ji’an Central People's Hospital from May 2022 to May 2024 were selected,they were divided into control group(31 cases)and study group(31 cases)according to random number table method.The control group was treated with Ambroxal,the study group was treated with intermittent subglottic lavage on the basis of the control group.The clinical efficacy of two groups was compared,the blood gas analysis and respiratory mechanics indexes of two groups were detected,and the occurrences of adverse reactions in two groups were recorded.Result:After treatment,the total effective rate of the study group was 93.55%,which was higher than 70.97%of the control group(P<0.05).After treatment,the pH and PaO_(2) levels were higher than those before treatment(P<0.05),and the PaCO_(2) levels were lower than before treatment(P<0.05);the pH and PaO_(2) levels of the study group were higher than those of the control group(P<0.05),and the PaCO_(2) level was lower than that of the control group(P<0.05).Before treatment,there were no statistical significances in the mean airway resistance and exhaled tidal volume between two groups(P>0.05);after treatment,the mean airway resistance in the two groups decreased and which in the study group was lower than that in the control group(P<0.05),and the exhaled tidal volume increased in two groups and which in the study group was higher than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between two groups(P>0.05).Conclusion:Intermittent subglottic lavage combined with high-dose Ambroxol Injection has significant clinical efficacy in the treatment of ICU severe pneumonia,and can effectively improve the blood gas indexes,pulmonary ventilation indexes,with high safety.