目的：观察盐酸氨溴索辅助治疗慢性阻塞性肺疾病（ COPD）伴肺部感染患者的效果及对肺功能、血气指标的影响。方法选取2014年1月—2016年1月辽宁省人民医院呼吸内二科治疗COPD合并肺部感染患者92例作为研究对象，按照随机数字表法分为观察组46例和对照组46例。对照组入院后行常规处理，给予患者吸氧、抗感染、解除支气管痉挛、纠正电解质紊乱、维持酸碱平衡、止咳祛痰、平喘、加强补液等常规治疗；观察组在对照组治疗基础上联合应用盐酸氨溴索；2组疗程均7 d。比较2组患者的临床疗效、临床症状改善时间、肺部感染评分（ CPIS）、急性生理学与慢性健康状况评分系统Ⅱ（ APACHEⅡ）、肺功能及血气指标变化情况。结果观察组总有效率显著高于对照组（91．3％vs．73．9％，χ2＝4．842， P ＝0．028）；治疗后观察组患者在咳嗽、咯痰、肺部湿啰音、胸闷气短缓解时间及住院时间均明显低于对照组（ t ＝164．197、8．209、2．872、6．925， P ＝0．000、0．000、0．003、0．000）；2组患者CPIS、APACHEⅡ评分均呈降低趋势，且观察组显著低于对照组（ t ＝20．464、12．765， P ＝0．000、0．000）；观察组FVC、FEV1、FEV1％、PaO2、PaCO2、pH值改善程度显著优于对照组（ t ＝9．276、7．633、7．302、6．726、3．491、5．416， P均＝0．000）；观察组治疗过程中发生胃部不适2例，口干症状1例，经对症处理后好转；对照组未发生不良反应，2组不良反应发生情况比较，差异无统计学意义（χ2＝2．225， P ＝0．136）。结论盐酸氨溴索辅助治疗COPD伴肺部感染患者疗效确切，能显著改善患者肺功能、血气指标、生存质量，安全有效。%Objective To observe of ambroxol hydrochloride in treatment of chronic obstructive pulmonary disease ( COPD) patients with pulmonary infection and its effect on lung function and blood gas index.Methods Ninety-two cases of patients with COPD and pulmonary infection were selected, which were treated in hospital from January 2014 to January 2016, and they were divided into the observation group (46 cases) and control group (46 cases).The patients of control group were treated with conventional treatment, including oxygen, antibiotics, bronchodilators relieve, correct electrolyte imbalance, maintain the acid base balance, cough expectorant, asthma, enhance rehydration and so on.On the basis of the control group, the patients of observation group were treated with ambroxol hydrochloride.The patients of two groups were all treated with continued seven days.Compare the clinical efficacy, clinical symptoms improved time and changes of thelevels of pulmonary infection score ( CPIS) , acute physiology and chronic health evaluationⅡ( APACHEⅡ) , lung function and blood gas of two groups.Results The total efficiency of the observation group was significantly higher than the control group ( 91.3% vs. 73.9% χ2 =4.842, P =0.028);after treatment, the patients in the observation group were cough, expectoration, pulmonary rales, shortness of breath response time and hospitalization time were significantly lower than the control group ( t =164.197, t =8.209, t =2.872, t =6.925, P =0.000, P =0.000, P =0.003, P =0.000);CPIS, APACHE score were decreased, and the observation group was significantly lower than the control group ( t =20.464, t =12.765, P =0.000, P =0.000);the observation group FVC, FEV1 , FEV1%, PaO2 , PaCO2 , pH values improved significantly better than control group ( t =9.276, t =7.633, t =7.302, t =6.726, t =3.491, t =5.416, all P <0.01);the observation group occurred during the treatment of stomach discomfort in 2 cases, 1 cases of dry mouth symptoms improved after symptomatic treatment;the control group had no adverse reaction, the incidence of adverse reactions of the 2 groups were compared, no difference Statistical sig-nificance (χ2 =2.225, P =0.136).Conclusion Ambroxol hydrochloride for the treatment of COPD with pulmonary infec-tion curative effect, can significantly improve the pulmonary function and blood gas indexes, life quality, safe and effective.
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