摘要
目的 观察吸入用乙酰半胱氨酸在重症肺炎并机械通气患者中的应用效果及对患者氧合指数、气道峰压(Ppeak)及痰液黏稠度的影响。方法 选取2020年5月—2021年5月贵阳市第二人民医院收治的重症肺炎并应用机械通气成人患者120例,采用随机数字表法分为观察组和对照组,各60例。所有患者入室后均接受常规治疗,在此基础上,对照组予布地奈德混悬液雾化吸入,观察组在对照组基础上加用乙酰半胱氨酸溶液雾化吸入。比较2组患者治疗前(入室时)和治疗后(治疗72 h)血气分析指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))]、Ppeak及痰液黏稠度变化。结果 治疗后,2组PaO_(2)、PaCO_(2)、PaO_(2)/FiO均较治疗前升高,Ppeak均降低,且观察组PaO_(2)/FiO_(2)、Ppeak升高或降低的程度大于对照组(P均<0.01);治疗后,2组痰液黏稠度均较治疗前降低,且观察组降低的程度大于对照组(Z=-2.216,P=0.027)。结论 吸入用乙酰半胱氨酸在重症肺炎并机械通气患者中的应用效果肯定,早期联用能够有效改善患者血氧指标,减少痰液分泌,明显改善痰液黏稠度,值得临床推广应用。
Objective To observe the application effect of acetylcysteine solution for inhalation in patients with severe pneumonia and mechanical ventilation,and its influence on oxygenation index,peak airway pressure(Ppeak)and sputum viscosity.Methods A total of 120 adult patients with severe pneumonia and mechanical ventilation admitted to Guiyang Second People′s Hospital from May 2020 to May 2021 were selected.The patients were divided into observation group and control group with 60 cases each by random number table.All patients received routine treatment after admission.On this basis,the control group was treated with budesonide suspension for inhalation aerosol inhalation,and the observation group was treated with acetylcysteine solution for inhalation aerosol inhalation on the basis of the control group.The changes of blood gas analysis indexes(PaO_(2),PaCO_(2),PaO_(2)/FiO_(2)),Ppeak and sputum viscosity were compared between the two groups before treatment and 72 hours after treatment.Results After treatment,PaO_(2),PaCO_(2),PaO_(2)/FiO_(2) in the two groups were higher than those before treatment,while Ppeak was lower than those before treatment,and the degree of increase or decrease of PaO_(2)/FiO_(2) and Ppeak in the observation group was greater than that in the control group(P<0.01).After treatment,the viscosity of sputum in both groups was lower than that before treatment,and the degree of reduction in the observation group was greater than that in the control group(Z=-2.216,P=0.027).Conclusion The application effect of acetylcysteine solution for inhalation in patients with severe pneumonia and mechanical ventilation is positive.Early combination can effectively improve the blood oxygen index of patients,reduce the secretion of sputum,and significantly improve the viscosity of sputum.It is worthy of clinical application.
作者
韩婷
苏应菊
莫逊
虞晓红
HAN Ting;SU Yingju;MO Xun;YU Xiaohong(EICU,Guiyang Second People′s Hospital,Guiyang 550002,China)
出处
《临床合理用药杂志》
2023年第14期14-17,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
重症肺炎
机械通气
吸入用乙酰半胱氨酸
吸入用布地奈德
Severe pneumonia
Mechanical ventilation
Acetylcysteine solution for inhalation
Budesonide suspension for inhalation
