Objective To study the effect of nebulized inhalation of ipratropium bromide and ambroxol hydrochloride (mucosolvan) on pulmonary function in elderly patients who need thoracotomy.Methods From June 2011 to December 2011,a total of 60 elderly patients undergoing thoracotomy were randomly divided into 2 groups:the treatment group (n =30) and control group (n=30).The patients in treatment group were treated with ipratropium bromide 0.5 mg and mucosolvan 15 mg diluted in 5 ml saline for inhalation with an oxygen flow rate of 6 L/min,15 min,3 times/d,and the patients in control group were treated with ipratropium bromide 0.5 mg diluted in 5 ml saline for inhalation with an oxygen flow rate of 6 L/min,15 min,3 times/d.The resting lung function in patients was measured before nebulization treatment.After 3 days treatment,the resting lung function was measured again,and vital capacity (VC),forced expiratory volume in one second (FEV1),FEV1 ％,maximal voluntary ventilation (MVV) were recorded.Results After 3 days treatment,the indicators of lung function including VC,FEV1,FEV1 ％,MVV were significantly increased in both groups (P＜0.01).The increase in VC,FEV1,FEV1 ％,MVV were significantly higher in the treatment group [(0.39±0.08)L,(0.20±0.10)L,(10.61±4.66)％,(10.24±5.07)L,respectively] than in control group [(0.31±0.05)L,(0.13±0.06)L,(7.40±3.89)％,(6.76±3.70)L,respectively] (t=4.81,3.64,4.13,3.48,all P＜0.05).The incidence of postoperative pulmonary complications was lower in treatment group[16.7 ％ (5/30)] than in control group [30.0 ％ (9/30)] (x2=11.45,P＜0.05).Conclusions The nebulized inhalation of ipratropium bromide and ambroxol hydrochoride can improve the lung function in elderly patients undergoing thoracic surgery,better withstand the thoracotomy and decrease the incidence of postoperative pulmonary complications.%目的 探讨异丙托溴铵(爱全乐)联合盐酸氨溴索(沐舒坦)雾化吸人改善需行胸部手术老年患者的肺功能疗效. 方法 收集2011年6-12月入院需行胸部手术的老年患者60例,随机分为试验组和对照组,每组30例.入院后均行静态肺功能,次日试验组给予爱全乐0.5 mg/次和沐舒坦15 mg/次,对照组给予爱全乐0.5 mg/次,均加入5 ml生理盐水稀释后以氧射流雾化吸入,氧流量为6 L/min,15 min/次,3次/d,连续雾化3d后再次行静态肺功能,记录结果；术后拔除气管插管后,雾化方法同术前,术后1周停用,比较两组肺功能指标变化及术后肺部并发症发生率. 结果 两组患者雾化吸入后肺活量(VC)、1 s内用力呼气容积(FEV1)、1 s用力呼气容积占用力肺活量比值(FEV1％)及最大自主通气量(MVV)等静息肺功能指标较雾化前均增高(均P＜0.05)；试验组肺功能指标升高较显著,试验组雾化前后VC、FEV1、FEV1％及MVV差值分别为(0.39±0.08)L、(0.20±0.10)L、(10.61±4.66)％、(10.24±5.07)L,较对照组(0.31±0.05)L、(0.13±0.06)L、(7.40±3.89)％、(6.76±3.70)L大(t=4.81、3.64、4.13、3.48,均P＜0.05).试验组患者术后肺部并发症发生率16.7％(5/30),低于对照组30.0％(9/30)(x2=11.45,P＜0.05) 结论 爱全乐联合沐舒坦雾化吸入能明显改善胸部手术老年患者的肺功能,更好地耐受开胸手术,两种药物联合使用效果优于单一用药且术后肺部并发症发生率下降.
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