盐酸氨溴索对小儿体外循环肺损伤的保护作用

目的:探讨盐酸氨溴索在小儿体外循环(CPB)手术中对肺的保护作用。方法:选择40例行房、室间隔缺损修补术的4～9岁的患儿,随机分为盐酸氨溴索组(M组)20例和对照组(C组)组20例。M组于麻醉后切皮前匀速静脉滴注盐酸氨溴索4.5mg/kg溶于50mL平衡液中,C组用等容量平衡盐溶液静脉注射,分别于麻醉后(T1)、给药后10min(T2)、停体外循环后5min(T3)、入ICU后1h(T4)、入ICU后2h(T5)、拔管前(T6),根据麻醉机及呼吸机记录气道峰压(PIP)和平台压(Plat)、气道阻力(R)及肺顺应性(CL)。采集静脉血液测定术前、术中、术后血白细胞(WBC)。结果:2组R处理因素与时间效应差异均有统计学意义(均P<0.01),2组在T5、T6时差异有统计学意义(P<0.01),2组均在T4时点达到最高值,以后呈下降趋势。2组患者CL在T1和T5时点差异均无统计学意义(P>0.05)。2组患者WBC组间和时间效应差异均有统计学意义(均P<0.01),处理因素与时间效应间存在交互作用(P<0.01)。2组PIP和Plat处理效应与时间效应差异均有统计学意义(均P<0.001);处理效应与时间效应存在交互作用(均P<0.01)。结论:在体外循环前使用盐酸氨溴索对肺有一定的保护作用。

The Protective Effect of Ambroxol on Lung Injury during Cardiopulmonary Bypass in Children

Objective:To investigate the protective effect of ambroxol on lung injury during cardiopulmonary bypass(CPB) in children.Methods:Forty patients aged 4-9,scheduled operation of atrial septal defect (asd)ventricular septal defect (vsd),were randomly allocated into two groups,ambroxol group (group M,n=20) and control group (group C,n=20).Ambroxol (4.5 mg/kg in 50 mL of saline) was injected before CPB in group M.The equal volume of normal saline was infused in group C.Blood samples were taken to detect white b...