氨溴索对心肺转流术后肺功能及血气分析的影响
|
摘要
目的探讨氨溴索对心脏手术行心肺转流术后肺功能及血气分析的影响。方法收集2016年1月—2016年12月江西中医药大学附属医院行心肺转流术患者共50例,按用药方法分为观察组和对照组,每组各25例。观察组在围手术期给予氨溴索治疗,对照组不用药物。检测两组术前、术后第7天肺功能、卵磷脂/鞘磷脂比值及动脉血气分析。结果两组术前1秒用力呼气容积(FEV1)、用力肺活量(FVC)、卵磷脂/鞘磷脂比值、PaO_2比较差异无统计学意义(P>0.05);术后两组FEV1、FVC、卵磷脂/鞘磷脂比值均较术前下降(P<0.05);且治疗组FEV1、FVC、卵磷脂/鞘磷脂比值、PaO_2均高于对照组(P<0.05)。两组术前、术后PaCO_2比较差异无统计学意义(P>0.05)。结论心肺转流术围手术期给予氨溴索可以显著改善肺功能和缺氧状态,临床疗效满意。
Objective To investigate effects of Ambroxol on postoperative pulmonary function and blood gas analysis after cardiopulmonary bypass in patients with cardiac surgery. Methods A total of 50 patients with cardiopulmonary bypass during January 2016 and December 2016 were divided into observation group( n = 25) and control group( n = 25)according to treatment methods. Observation group was treated with Ambroxol,while control group did not receive any medication during peroperative period. Pulmonary function conditions,PaO_2,arterial blood gas and lecithin/sphingomyelin ratio were detected before and the 7 thd after operation in two groups. Results Before operation,there were no significant differences in forced expiratory volume in one second( FEV1),forced vital capacity( FVC),lecithin/sphingomyelin ratio or PaO_2 in two groups( P > 0. 05); after operation,FEV1,FVC and lecithin/sphingomyelin ratio values were significantly decreased than those before operation in two groups( P < 0. 05),and the FEV1,FVC,lecithin/sphingomyelin ratio and PaO_2 values in observation group were significantly higher than those in control group( P < 0. 05). There were no significant differences in arterial carbon dioxide tension( PaCO_2) and PaO_2 values before and after operation in two groups( P >0. 05). Conclusion Ambroxol in application of patients with cardiac surgery after cardiopulmonary bypass during peroperative period may effectively improve postoperative pulmonary function and anerobic condition with good effect.
Objective To investigate effects of Ambroxol on postoperative pulmonary function and blood gas analysis after cardiopulmonary bypass in patients with cardiac surgery. Methods A total of 50 patients with cardiopulmonary bypass during January 2016 and December 2016 were divided into observation group( n = 25) and control group( n = 25)according to treatment methods. Observation group was treated with Ambroxol,while control group did not receive any medication during peroperative period. Pulmonary function conditions,PaO_2,arterial blood gas and lecithin/sphingomyelin ratio were detected before and the 7 thd after operation in two groups. Results Before operation,there were no significant differences in forced expiratory volume in one second( FEV1),forced vital capacity( FVC),lecithin/sphingomyelin ratio or PaO_2 in two groups( P > 0. 05); after operation,FEV1,FVC and lecithin/sphingomyelin ratio values were significantly decreased than those before operation in two groups( P < 0. 05),and the FEV1,FVC,lecithin/sphingomyelin ratio and PaO_2 values in observation group were significantly higher than those in control group( P < 0. 05). There were no significant differences in arterial carbon dioxide tension( PaCO_2) and PaO_2 values before and after operation in two groups( P >0. 05). Conclusion Ambroxol in application of patients with cardiac surgery after cardiopulmonary bypass during peroperative period may effectively improve postoperative pulmonary function and anerobic condition with good effect.
引文
[1]Pang X Y,Fang C C,Chen Y Y,et al.Effects of Ulinastatin on Perioperative Inflammatory Response and Pulmonary Function in Cardiopulmonary Bypass Patients[J].Am J Ther,2016,23(6):e1680-e1689.
[2]肖颖琨,李天远,曾庆诗,等.乌司他丁对单肺通气和体外循环下行胸腔镜心脏手术患者肺功能的影响[J].广东医学,2015,36(6):949-952.
[3]黎笔熙,朱水波,殷桂林,等.盐酸戊乙奎醚对体外循环心脏手术患者全身炎症反应的影响[J].中国体外循环杂志,2016,14(4):222-225.
[4]Fal A M,Schonknecht K.Efficacy and safety of acute bronchitis treatment in adults--a comparison of Bronchosol(R)syrup and synthetic preparations with ambroxol.Results of observational study[J].Wiad Lek,2015,68(2):139-144.
[5]梁笛,王桂芳.化痰药物氨溴索的非化痰作用研究进展[J].复旦学报:医学版,2011,38(6):553-555,564.
[6]胡萍,姜志斌,许蓼梅,等.零平衡超滤和改良超滤联合应用对婴幼儿心脏手术后肺功能的影响[J].中南大学学报:医学版,2014,39(7):698-702.
[7]沈赛娥,王英伟.体外循环期间不同通气模式对心脏手术患者肺功能的影响[J].上海交通大学学报:医学版,2010,30(7):843-847,864.
[8]高阳,程远大,董硕,等.围术期应用氨溴索对胸腔镜下肺叶切除术后肺癌患者的作用[J].中南大学学报:医学版,2014,39(8):849-854.
[9]段玲,欧阳刚,赵亮,等.大剂量氨溴索在重症肺炎治疗中价值[J].临床肺科杂志,2014,19(8):1403-1405.
[10]黄维红,李燕.氨溴索不同给药方式治疗小儿肺炎疗效观察[J].现代仪器与医疗,2015,21(3):108-109.
[11]李东旭,李鹏,周阳.布地奈德联合氨溴索雾化吸入治疗卒中相关性肺炎疗效观察[J].武警后勤学院学报:医学版,2012,21(12):990-991,994.
[12]苏鹏飞,李伟,段东奎.大剂量氨溴索在肺叶切除围术期对肺功能的保护作用[J].中国老年学杂志,2014,34(8):2124-2125.
[13]郑鑫,张延钧,田嘉欣,等.大剂量氨溴索在气道高反应患者术中的应用[J].中国医药,2013,8(10):1398-1399.
[14]闫菲,赵桂华,徐金义.300例大气道阻塞病变的肺功能分析[J].临床肺科杂志,2017,22(5):854-857.
[15]汪征兵,江海兵,徐大林,等.动脉血气分析鉴别慢性阻塞性肺疾病与慢性心功能不全[J].临床肺科杂志,2012,17(1):134-135.
[16]李伟,李妍,王民,柴琳琳,等.不同水平的呼气末正压对胸腔镜肺大疱切除术单肺通气患者血气分析及血流动力学影响[J].现代仪器与医疗,2016,22(3):55-56.
[17]吕定量,万海军.氨溴索对体外循环下心脏手术患者围术期的肺、肾功能影响[J].心电与循环,2016,35(4):261-265.
[18]邱银燕,金秀峰,许尚栋,等.心脏术后麻醉合并症及相关处理[J].首都医科大学学报,2015,36(3):382-387.
[19]Ulas M M,Hizarci M,Kunt A,et al.Protective effect of ambroxol on pulmonary function after cardiopulmonary bypass[J].J Cardiovasc Pharmacol,2008,52(6):518-523.
[20]Besnard A E,Wirjosoekarto S A,Broeze K A,et al.Lecithin/sphingomyelin ratio and lamellar body count for fetal lung maturity:a meta-analysis[J].Eur J Obstet Gynecol Reprod Biol,2013,169(2):177-183.
[2]肖颖琨,李天远,曾庆诗,等.乌司他丁对单肺通气和体外循环下行胸腔镜心脏手术患者肺功能的影响[J].广东医学,2015,36(6):949-952.
[3]黎笔熙,朱水波,殷桂林,等.盐酸戊乙奎醚对体外循环心脏手术患者全身炎症反应的影响[J].中国体外循环杂志,2016,14(4):222-225.
[4]Fal A M,Schonknecht K.Efficacy and safety of acute bronchitis treatment in adults--a comparison of Bronchosol(R)syrup and synthetic preparations with ambroxol.Results of observational study[J].Wiad Lek,2015,68(2):139-144.
[5]梁笛,王桂芳.化痰药物氨溴索的非化痰作用研究进展[J].复旦学报:医学版,2011,38(6):553-555,564.
[6]胡萍,姜志斌,许蓼梅,等.零平衡超滤和改良超滤联合应用对婴幼儿心脏手术后肺功能的影响[J].中南大学学报:医学版,2014,39(7):698-702.
[7]沈赛娥,王英伟.体外循环期间不同通气模式对心脏手术患者肺功能的影响[J].上海交通大学学报:医学版,2010,30(7):843-847,864.
[8]高阳,程远大,董硕,等.围术期应用氨溴索对胸腔镜下肺叶切除术后肺癌患者的作用[J].中南大学学报:医学版,2014,39(8):849-854.
[9]段玲,欧阳刚,赵亮,等.大剂量氨溴索在重症肺炎治疗中价值[J].临床肺科杂志,2014,19(8):1403-1405.
[10]黄维红,李燕.氨溴索不同给药方式治疗小儿肺炎疗效观察[J].现代仪器与医疗,2015,21(3):108-109.
[11]李东旭,李鹏,周阳.布地奈德联合氨溴索雾化吸入治疗卒中相关性肺炎疗效观察[J].武警后勤学院学报:医学版,2012,21(12):990-991,994.
[12]苏鹏飞,李伟,段东奎.大剂量氨溴索在肺叶切除围术期对肺功能的保护作用[J].中国老年学杂志,2014,34(8):2124-2125.
[13]郑鑫,张延钧,田嘉欣,等.大剂量氨溴索在气道高反应患者术中的应用[J].中国医药,2013,8(10):1398-1399.
[14]闫菲,赵桂华,徐金义.300例大气道阻塞病变的肺功能分析[J].临床肺科杂志,2017,22(5):854-857.
[15]汪征兵,江海兵,徐大林,等.动脉血气分析鉴别慢性阻塞性肺疾病与慢性心功能不全[J].临床肺科杂志,2012,17(1):134-135.
[16]李伟,李妍,王民,柴琳琳,等.不同水平的呼气末正压对胸腔镜肺大疱切除术单肺通气患者血气分析及血流动力学影响[J].现代仪器与医疗,2016,22(3):55-56.
[17]吕定量,万海军.氨溴索对体外循环下心脏手术患者围术期的肺、肾功能影响[J].心电与循环,2016,35(4):261-265.
[18]邱银燕,金秀峰,许尚栋,等.心脏术后麻醉合并症及相关处理[J].首都医科大学学报,2015,36(3):382-387.
[19]Ulas M M,Hizarci M,Kunt A,et al.Protective effect of ambroxol on pulmonary function after cardiopulmonary bypass[J].J Cardiovasc Pharmacol,2008,52(6):518-523.
[20]Besnard A E,Wirjosoekarto S A,Broeze K A,et al.Lecithin/sphingomyelin ratio and lamellar body count for fetal lung maturity:a meta-analysis[J].Eur J Obstet Gynecol Reprod Biol,2013,169(2):177-183.