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目的探讨大剂量沐舒坦对老年重症肺炎的临床疗效。方法 90例老年重症肺炎作为临床研究对象,将所有患者随机分为实验组和对照组,每组45例,对照组患者采用常规剂量沐舒坦治疗,实验组则采用大剂量沐舒坦治疗。观察两组血气分析指标结果、机械通气时间、重症监护时间和不良反应发生率,以比较两组疗效和安全性。结果两组患者在动脉氧分压(PaO2)、动脉血氧饱和度(SaO2)与动脉氧分压/吸入氧浓度(PaO2/FiO2)上的差异均有统计学意义(P<0.05),实验组[(78.9±5.7)、(93.9±6.2)、(240.2±32.8)]显著高于对照组[(65.3±4.1)、(88.9±4.6)、(196.3±30.6)]。两组患者平均机械通气时间与重症监护时间差异有统计学意义(P<0.05),实验组[(2.6±1.5)、(5.7±1.3)]优于对照组[(5.4±2.6)、(8.8±2.8)]。两组患者均无严重不良反应,只有实验组1例患者在用药时有轻微恶心,在减慢滴注速度后症状消失。两组比较,不良反应发生率差异无统计学意义(P>0.05)。结论大剂量应用沐舒坦治疗老年重症肺炎,能显著改善患者症状体征,同时缩短机械通气时间和重症监护停留时间,安全性佳,值得在今后临床工作中推广应用。
Objective To investigate the clinical effect of high-dose ambroxol on elderly severe pneumonia. Methods Ninety elderly patients with severe pneumonia were enrolled in this study. All patients were randomly divided into experimental group and control group, with 45 cases in each group. Patients in control group were treated with conventional dosage of mucosolvan, while those in experimental group were treated with large dose of mucosolvan. Two sets of blood gas analysis index results, mechanical ventilation time, intensive care time and incidence of adverse reactions were observed to compare the efficacy and safety of the two groups. Results The differences of PaO2, SaO2 and PaO2 / FiO2 between the two groups were statistically significant (P <0.05). Experiment (78.9 ± 5.7), (93.9 ± 6.2) and (240.2 ± 32.8) in the control group were significantly higher than those in the control group [(65.3 ± 4.1), (88.9 ± 4.6), (196.3 ± 30.6)], respectively. The mean duration of mechanical ventilation and intensive care between the two groups were statistically significant (P <0.05), and the scores in the experimental group [(2.6 ± 1.5) and (5.7 ± 1.3)] were significantly higher than those in the control group [(5.4 ± 2.6) and ± 2.8)]. There were no serious adverse reactions in both groups. Only 1 patient in the experimental group had slight nausea during medication, and the symptoms disappeared after slowing infusion rate. There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion High-dose application of Mucosolvan in the treatment of severe pneumonia in elderly patients can significantly improve symptoms and signs of patients, meanwhile, shorten the duration of mechanical ventilation and intensive care stay, which is safe and worthy of popularization and application in future clinical work.