福多司坦治疗全麻插管术后咳嗽及预防术后肺炎的临床疗效研究
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摘要
目的探讨福多司坦治疗全麻插管术后咳嗽及预防术后肺炎的临床疗效。方法选取徐州医科大学附属淮安医院2018年1-12月收治的282例麻醉插管术后咳嗽患者作为研究对象。将患者随机分为3组:福多司坦组(n=94)、氨溴索组(n=94)、对照组(n=94)。观察患者术后咳嗽改善效果及术后肺炎(POP)的发生情况。结果福多司坦组、氨溴索组、对照组术后咳嗽治疗有效率分别为90.43%、85.11%和62.77%,福多司坦组与氨溴索组的治疗有效率高于对照组(P<0.01)。3组患者的咳嗽体征好转时间差异有统计学意义(P<0.05),福多司坦组与氨溴索组体征好转所用时间短于对照组。福多司坦组、氨溴索组、对照组POP发生率差异有统计学意义(P<0.05),其中福多司坦组和氨溴索组POP发生率低于对照组。福多司坦组及氨溴索组术后1周PCT、血沉水平明显低于对照组,差异有统计学意义(P均<0.05)。结论福多司坦治疗全麻插管术后咳嗽有一定的疗效,并且对术后肺炎具有良好的预防效果,可降低术后肺炎的发生率。
Objective To investigate the clinical efficacy of Fudosteine in the treatment of cough and prevention of pneumonia after general anesthesia intubation. Methods 282 patients with cough after anesthesia intubation were selected from our hospital from January to December 2018. The patients were randomly divided into fodostein group(n=94), ambroxol group(n=94), and control group(n=94). The effect of cough improvement and the incidence of post-operative pneumonia(POP) were observed. Results The effective rates of the three groups were 90.43%, 85.11% and 62.77%, respectively. The effective rates of the fodostein group and ambroxol group were higher than those of the control group(P<0.01). There was significant difference in the improvement time of cough signs among the three groups(P<0.05). It took less time for signs to improve in the Fudosteine group and ambroxol group than in the control group. There were significant difference of the incidence of POP between Fudosteine group, Ambroxol group and control group(P=0.037). The incidence of POP in Fudosteine group and Ambroxol group was lower than that in control group. one week after operation, the PCT and ESR in Fudosteine group and ambroxol group were significantly lower than those in control group(P<0.05). Conclusion Fudosteine is effective in the treatment of cough after general anesthesia intubation, and has a good preventive effect on post-operative pneumonia, which can reduce the incidence of post-operative pneumonia.
Objective To investigate the clinical efficacy of Fudosteine in the treatment of cough and prevention of pneumonia after general anesthesia intubation. Methods 282 patients with cough after anesthesia intubation were selected from our hospital from January to December 2018. The patients were randomly divided into fodostein group(n=94), ambroxol group(n=94), and control group(n=94). The effect of cough improvement and the incidence of post-operative pneumonia(POP) were observed. Results The effective rates of the three groups were 90.43%, 85.11% and 62.77%, respectively. The effective rates of the fodostein group and ambroxol group were higher than those of the control group(P<0.01). There was significant difference in the improvement time of cough signs among the three groups(P<0.05). It took less time for signs to improve in the Fudosteine group and ambroxol group than in the control group. There were significant difference of the incidence of POP between Fudosteine group, Ambroxol group and control group(P=0.037). The incidence of POP in Fudosteine group and Ambroxol group was lower than that in control group. one week after operation, the PCT and ESR in Fudosteine group and ambroxol group were significantly lower than those in control group(P<0.05). Conclusion Fudosteine is effective in the treatment of cough after general anesthesia intubation, and has a good preventive effect on post-operative pneumonia, which can reduce the incidence of post-operative pneumonia.
引文
[1] 崔楚云,宫尚群,金昌德.甘草用于预防气管插管全身麻醉术后病人咽喉痛和咳嗽效果的Meta分析[J].护理研究,2018,32(8):1255-1262.
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[9] 《应用抗菌药物防治外科感染的指导意见》撰写协作组. 应用抗菌药物防治外科感染的指导意见ⅩⅪ--手术后肺炎[J]. 中国实用外科杂志, 2004, 43(2):1158-1160.
[10] 李刚,王健生,秦思达,等.布地奈德联合氨溴索氧化驱动雾化吸入预防成人开胸术后肺炎的临床疗效[J].北京大学学报(医学版),2018,50(5):840-844.
[11] 杨红晖, 姚小红, 黄秀良, 等.全麻气管插管术后患者肺部感染的调查分析[J].中华医院感染学杂志, 2009, 21 (19) :2868-2869.
[12] 曹洪森. 567例老年患者全身麻醉气管插管后下呼吸道感染病原菌特点分析及危险因素[J].中国微生态学杂志, 2016, 28 (6) :716-718, 721.
[13] 刘阳,张影,魏大力.全麻气管插管术后获得性肺炎的危险因素分析与预防[J].中华医院感染病学杂志,2013,23(19):4674-4675.
[14] CERNADA M, AGUAR M, BRUGADA M, et al. Ventilator-associated pneumonia in newborn infants diagnosed with an invasive bronchoalveolar lavage technique:a prospective observational study[J]. Pediatr Crit Care Med, 2013, 14(1):55-61.
[2] 何玉莲,黎尚荣,高婉菱,等.布托啡诺在全身麻醉后气管拔管期的应用[J].实用医学杂志,2007,23(6):818-820.
[3] 汪爱民.福多司坦的药理作用与临床应用研究进展[J].医药导报,2006,25(增刊):103-104.
[4] 张晓菊,辛建保,张建初,等.福多司坦片治疗慢性呼吸道疾病的祛痰作用观察[J].医药导报,2007,26(11):1306-1308.
[5] 周颖.福多司坦治疗慢性阻塞性肺疾病急性加重患者的临床观察[J].中国临床药理学与治疗学,2012,17(3):334-337.
[6] 中华预防医学会医院感染控制分会第四届委员会.术后肺炎预防和控制专家共识[J].中华临床感染病杂志,2018,11(1):11-19.
[7] 程钧,曹隆想,牛越群,等.普胸外科术后慢性咳嗽相关因素分析[J].中华胸部外科电子杂志,2017,4(3):177-180.
[8] 赵国义,栾磊,程曼璐,等.术后肺炎患者相关因素及干预的研究[J].齐齐哈尔医学院学报,2010,31(14):2219-2220.
[9] 《应用抗菌药物防治外科感染的指导意见》撰写协作组. 应用抗菌药物防治外科感染的指导意见ⅩⅪ--手术后肺炎[J]. 中国实用外科杂志, 2004, 43(2):1158-1160.
[10] 李刚,王健生,秦思达,等.布地奈德联合氨溴索氧化驱动雾化吸入预防成人开胸术后肺炎的临床疗效[J].北京大学学报(医学版),2018,50(5):840-844.
[11] 杨红晖, 姚小红, 黄秀良, 等.全麻气管插管术后患者肺部感染的调查分析[J].中华医院感染学杂志, 2009, 21 (19) :2868-2869.
[12] 曹洪森. 567例老年患者全身麻醉气管插管后下呼吸道感染病原菌特点分析及危险因素[J].中国微生态学杂志, 2016, 28 (6) :716-718, 721.
[13] 刘阳,张影,魏大力.全麻气管插管术后获得性肺炎的危险因素分析与预防[J].中华医院感染病学杂志,2013,23(19):4674-4675.
[14] CERNADA M, AGUAR M, BRUGADA M, et al. Ventilator-associated pneumonia in newborn infants diagnosed with an invasive bronchoalveolar lavage technique:a prospective observational study[J]. Pediatr Crit Care Med, 2013, 14(1):55-61.