大剂量氨溴索对ARDS患者氧合指数和病死率的影响

目的观察大剂量氨溴索对急性呼吸窘迫综合征（ARDS）患者氧合指数和病死率的影响。方法将86例入住ICU的ARDS患者随机分成大剂量氨溴索治疗组（观察组）和对照组。对照组采用常规综合治疗和机械通气治疗,观察组在对照组治疗的基础上加用大剂量氨溴索15mg∕（kg.d）]分3次静脉滴注治疗,共7d。观察两组患者治疗前后呼吸频率、氧合指数（PaO2/FiO2）和PaCO2的变化,记录两组患者28d病死率。结果两组患者入ICU时年龄、呼吸频率（次/min）、PaO2/FiO2以及PaCO2（mmHg）比较差异均无统计学意义（P〉0.05）。治疗7d后观察组呼吸频率明显比对照组慢（19.5±5.6）VS（28.0±4.9）],差异有统计学意义（P〈0.01）;观察组PaO2/FiO2明显比对照组高（356.0±36.7）VS（290.6±32.3）],差异有统计学意义（P〈0.01）;观察组PaCO2与对照组比较差异有统计学意义（P〈0.01）,但两组患者PaCO2值均在正常范围内;观察组28d病死率虽比对照组低（23.3%VS 30.23%）,但差异无统计学意义（P〉0.05）。结论大剂量氨溴索能提高ARDS患者的氧合指数,改善呼吸功能。

Effects of large dose ambroxol on oxygenation index and mortality in patients with ARDS

Objective To study effects of large dose ambroxol on oxygenation index and mortality in patients with ARDS.Methods 86 patients with acute respiratory distress syndrome were divided into large dose ambroxol treatment group and control group.The patients in two groups were treated by using regular treatment and mechanical ventilation,and in the large dose ambroxol treatment group were extra treated by using large dose ambroxol 15mg∕（kg·d） intravenously guttae（5mg∕kg every 8 hours） for 7 days.The effect of therapy in both group was evaluated with respiratory rate,oxygenation index（PaO_2/FiO_2）,PaCO_2 and mortality of 28 days.Results There were no differences in age,respiratory rate,oxygenation index（PaO_2/FiO_2）and PaCO_2 between two groups before treatment（P0.05）.The respiratory rate in the large dose ambroxol treatment group was significantly lower than it in control group（19.5±5.6） VS（28.0±4.9）,（P0.01）].The oxygenation index（PaO_2/FiO_2）in the large dose ambroxol treatment group was significantly higher than it in control group（356.0±36.7） VS（290.6±32.3）,（P0.01）].The PaCO_2 although in the large dose ambroxol treatment group was significantly higher than it in control group（P0.01）,but both groups were in normal.There were no statistical differences in mortality of 28 days between two groups（P0.05）,although it in the large dose ambroxol treatment group was lower than in control group.Conclusion Treatment with large dose ambroxol can improve oxygenation index and pulmonary function in patients with ARDS.