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目的探讨肺癌患者围术期应用氨溴索联合异丙托溴铵雾化吸入的效果。方法选取2015年10月至2017年2月于朝阳市中心医院心胸外科行胸腔镜肺癌手术的患者61例为研究对象,随机分为研究组和对照组。研究组30例患者在常规呼吸功能训练的基础上术前及术后5 d行氨溴索联合异丙托溴铵超声波雾化吸入,对照组31例患者术前单纯行常规呼吸功能训练及术后5 d行氨溴索联合异丙托溴铵超声波雾化吸入,比较两组患者入院时、术前及术后5 d肺功能和血气分析指标,以及术后吸痰次数、吸氧时间和肺部并发症情况。结果研究组患者经雾化吸入治疗后,术前每分钟最大通气量、第一秒用力呼气量、用力肺活量和动脉氧分压高于对照组,差异有统计学意义(P<0.05)。研究组患者术后5 d第一秒用力呼气量和用力肺活量高于对照组,差异有统计学意义(P<0.05)。两组患者术后吸氧时间比较,差异无统计学意义(P>0.05)。研究组患者平均吸痰(1.8±1.1)次,对照组(2.7±1.4)次,两组差异有统计学意义(P<0.05)。两组患者术后肺不张、肺部感染和发热等肺部并发症发生率比较,差异无统计学意义(P>0.05),但肺部并发症总发生率差异有统计学意义(P<0.05)。结论围术期应用氨溴索联合异丙托溴铵雾化吸入可以有效改善肺癌患者的肺功能,降低术后肺部并发症的发生率。
Objective To investigate the effect of inhalation of ambroxol and ipratropium bromide in patients with lung cancer during perioperative period. Methods From October 2015 to February 2017, 61 patients undergoing thoracoscopic lung cancer surgery underwent cardiothoracic surgery at Chaoyang Central Hospital were selected as study subjects and randomly divided into study group and control group. 30 patients in the study group were given inhalation of ambroxol combined with ipratropium bromide on the basis of routine respiratory function training and 5 days after the operation. The control group of 31 patients were simply routine routine respiratory function training and surgery After 5 days, ambroxol and ipratropium bromide were inhaled. The pulmonary function and blood gas analysis indexes were compared between the two groups before admission and 5 days after operation, and the number of postoperative sputum aspiration, oxygen inhalation time and Pulmonary complications. Results After inhalation therapy, the maximal preoperative minute ventilation, forced expiratory volume in the first second, forced vital capacity and arterial oxygen pressure in the study group were significantly higher than those in the control group (P <0.05). The forced expiratory volume and forced vital capacity of the study group were higher than those of the control group on the 5th day after operation, the difference was statistically significant (P <0.05). There was no significant difference in oxygen absorption time between the two groups (P> 0.05). In the study group, the mean number of sputum aspirates was (1.8 ± 1.1) times and in the control group (2.7 ± 1.4), there was significant difference between the two groups (P <0.05). There was no significant difference in the incidence of pulmonary complications such as atelectasis, pulmonary infection and fever between the two groups (P> 0.05), but the total incidence of pulmonary complications was significantly different (P < 0.05). Conclusion Perioperative inhalation of ambroxol combined with ipratropium bromide can effectively improve lung function in patients with lung cancer and reduce the incidence of postoperative pulmonary complications.