Objective To study the effect of high-dose ambroxol combined with fiberoptic bronchoscopy in the treatment of severe pneumonia in the elderly. Methods One hundred and forty-two senior patients with severe pneumonia were selected in intensive care unit (ICU) and divided into the control group and the study group. Patients in the control group (n=70) were treated with standard-dose ambroxol (30 mg, 3 times per day)) and the vibration row of phlegm meter. The study group (n=72) were given high-dose ambroxol (1 005 mg, once per day) combined with the fiberoptic bronchoscopy for 7 days. The blood gas analysis, plasma PCT, CRP level, APACHEII, time of ventilator, the incidence rate of multiple organ failure and 28-day mortality rate were compared between the two groups. The changes and differences of clinical and prognostic factors were compared. Results The oxygenation indexes, PCT, CRP levels of the study group were significantly improved than those of the control group. The time of ventilator, incidence of multiple organ failure and 28-day mortality rate were remarkably reduced compared with the control group. Conclusion High-dose ambroxol combined with fiberoptic bronchoscopy can help control the severe pneumonia, and reduce the mortality rate.%目的 评价大剂量盐酸氨溴索联合纤维支气管镜吸痰治疗对老年重症肺炎的临床价值.方法 将142例入住ICU的重症肺炎患者按家属知情同意分为两组,治疗组72例和对照组70例,在常规治疗的基础上,治疗组应用大剂量盐酸氨溴索(1 005 mg/d),并联合纤维支气管镜灌洗治疗；对照组为常规剂量盐酸氨溴索(30 mg,3次/d)联合振动排痰仪等排痰措施祛痰治疗,不采用支气管镜灌洗治疗.比较两组患者治疗前后血气分析、降钙素原(PCT)、C反应蛋白(CRP)呼吸机带机时间、多器官功能衰竭(MOF)发生率及28 d病死率有无差异.结果 治疗组老年重症肺炎患者氧合指数及炎性指标PCT、CRP均较对照组明显好转(P＜0.05)；治疗组患者呼吸机带机时间、多器官功能衰竭发生率和28 d病死率均明显低于对照组.结论 大剂量氨溴索联合纤维支气管镜灌洗治疗能够增加老年重症肺炎的治疗效果,降低病死率.
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