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布地奈德联合复方异丙托溴铵雾化吸入对尘肺病大容量全肺灌洗围术期患者的疗效影响
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| 篇名： | 布地奈德联合复方异丙托溴铵雾化吸入对尘肺病大容量全肺灌洗围术期患者的疗效影响 |
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| 摘要： | 目的： 探讨布地奈德联合复方异丙托溴铵雾化吸入对尘肺病大容量全肺灌洗（WLL）围术期患者的疗效和安全性影响。方法：选取我院2014年12月－2016年5月全身麻醉完成WLL术的尘肺病男性患者150例，按照随机数字表法分为治疗组和对照组，各75例。两组患者均采用全身静脉复合麻醉，并采用WLL术和间歇与呼吸机呼吸频率同步的纯氧手动正压通气交替负压吸引；治疗组患者在术前3 d至术后3 d给予吸入用布地奈德混悬液2 mL，bid+吸入用复方异丙托溴铵溶液2.5 mL，tid，雾化吸入。观察两组患者不同灌洗阶段的动脉血气指标[血酸碱度（pH）、血氧分压（PaO2）、血二氧化碳分压（PaCO2）和剩余碱（BE）]水平，术前3 d和术后7 d的肺功能指标[用力肺活量（FVC）、最大通气量（MVV）和第一秒用力呼气容积（FEV1）占FVC比值]水平、血气指标水平和临床症状评分，并记录不良反应发生情况。结果：单/双侧肺灌洗毕双肺通气20 min后，两组患者PaO2均较术前明显升高，差异有统计学意义（P＜0.05），但组间比较差异无统计学意义（P＞0.05）。术后3 d，两组患者FVC、MVV、FEV1/FVC、PaO2均明显升高，PaCO2和临床症状评分均明显降低，且治疗组患者FVC、 FEV1/FVC、PaO2和临床症状评分明显优于对照组，差异有统计学意义（P＜0.05）。治疗组患者气道痉挛、低氧血症和气道压增高的发生率均明显低于对照组，差异有统计学意义（P＜0.05）。结论：给予WLL围术期的尘肺病患者布地奈德联合复方异丙托溴铵雾化吸入的辅助治疗，可提高WLL的临床疗效，减少术中不良反应的发生。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of aerosol inhalation of budesonide combined with Compound ipratropium bromide on therapeutic efficacy and safety of patients with pneumoconiosis during perioperative period of massive whole-lung lavage （WLL）. METHODS： One hundred and fifty male patients with pneumoconiosis receiving WLL under general anesthesia selected from our hospital during Dec. 2014-May 2016 were divided into treatment group and control group in accordance with random number table， with 75 cases in each group. Both groups received WLL under general anesthesia as well as pure-oxygen manual positive pressure ventilation alternating with negative pressure drainage keeping interval and respiratory rate of ventilator synchronization. Treatment group was given Budesonide suspension 2 mL， bid+ Compound ipratropium bromide solution 2.5 mL， tid， by aerosol inhalation from 3 d before surgery to 3 d after surgery. The levels of arterial blood gas indexes （pH， PaO2， PaCO2， BE） at different lavage stages， lung function indexes （FVC， MVV， FEV1/FVC）， blood gas indexes and clinical symptom score 3 d before surgery and 7 d after surgery were observed in 2 groups， and the occurrence of ADR was recorded. RESULTS： After two-lung ventilation for 20 min following unilateral/bilateral lung lavage， PaO2 of 2 groups were all increased significantly compared to before surgery， with statistical significance （P＜0.05）； but there was no statistical significance between 2 groups （P＞0.05）. three days after surgery， FVC， MVV， FEV1/FVC and PaO2 of 2 groups were all increased significantly， PaCO2 and clinical symptom score were all decreased significantly. FVC， FEV1/FVC， PaO2 and clinical symptom score of treatment group were significantly better than those of control group， with statistical significance （P＜0.05）. The incidence of airway spasm， hypoxemia and airway pressure increasing in treatment group were significantly lower than in control group， with statistical significance （P＜0.05）. CONCLUSIONS： During perioperative period of WLL， the aerosol inhalation of budesonide combined with Compound ipratropium bromide for patients with pneumoconiosis can improve clinical efficacy of WLL and reduce the occurrence of ADR during surgery. |
| 期刊： | 2017年第28卷第5期 |
| 作者： | 杨怀宇，石江涛 |
| AUTHORS： | YANG Huaiyu，SHI Jiangtao |
| 关键字： | 布地奈德；复方异丙托溴铵；尘肺病；大容量全肺灌洗；雾化吸入 |
| KEYWORDS： | Budesonide； Compound ipratropium bromide； Pneumoconiosis； Massive whole-lung lavage； Aerosol inhalation |
| 阅读数： | 472 次 |
| 本月下载数： | 1 次 |
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