Effects of airway humidification with different doses of ambroxol to tracheotomy
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摘要: 目的 明确氨溴索湿化液在气道湿化中的临床应用价值,并探讨不同剂量氨溴索湿化液应用于气管切开患者的湿化效果,为形成科学的、健全的、系统的气道湿化方案提供新思路。 方法 选取2016年1月-2017年1月在湖州市中心医院重症医学科进行气管切开的患者80例,使用随机数字表法将患者分A组(无氨溴索)、B组(氨溴索30 mg/d)、C组(氨溴索60 mg/d)、D组(氨溴索90 mg/d),每组各20例。观测4组患者在第3、5、7天的气道湿化效果及其不良反应。 结果 在气道湿化后的第3、5、7天,4组患者痰液黏稠度的差异均无统计学意义(均P>0.05);而B、C、D三组在升高痰液pH值和降低痰液Ca2+值、α1-酸性糖蛋白值的效果上要明显优于A组(均P<0.05),且剂量越大效力越强,但吸痰次数也会增多;4组患者在刺激性呛咳和气道黏膜出血的发生率上,差异均无统计学意义(均P>0.05);D组可能存在药物副反应的风险。 结论 对气管切开患者来说,使用氨溴索湿化液微泵持续气道内湿化的方案是值得推荐的;其中30 mg/d剂量适用于住院时间较长的患者;60 mg/d剂量适用于住院时间较短或者病情需短时间内达到湿化效果的患者;90 mg/d剂量适用于抢救患者或者痰栓较多而极易阻塞气道的患者,使用时应密切监测患者的尿酸。Abstract: Objective To clarify the clinical value of using Ambroxol in tracheotomy, and investigate the effects of different doses of Ambroxol to airway humidification for tracheotomy, and provide a new idea for the scientific, wholesome, systematic humidification solutions. Methods A total of 80 tracheotomy patients in our hospital between January, 2016 and January, 2017 were divided into group A (no Ambroxol), group B (30 mg/d Ambroxol), group C (60 mg/d Ambroxol), group D (90 mg/d Ambroxol) according to random number table, with 20 cases in each group. The effects of airway humidification among the four groups in the 3rd, 5th and 7th day were compared. Results In the 3rd, 5th and 7th day after humidifying, there was no statistically difference (P>0.05) in the viscosity of sputum among the four groups. The rising sputum pH value and reducing sputum Ca2+ value and α1-Acid glycoprotein value in the group B (30 mg/d), group C (60 mg/d)and group D (90 mg/d) which contained Ambroxol were better than that in group A (no Ambroxol), P<0.05. The higher dose of the Ambroxol used, the stronger effect it would be, but the number of sputum aspiration was increased. In the incidence of stimulating choking cough and airway mucosa bleeding, there was no statistically difference (P>0.05) among the four groups. Group D (90 mg/d) might have the risk of medication side effects. Conclusion For tracheotomy, it is effective to use Ambroxol to continuous airway humidification by micro pump. The dose of 30 mg/d is suitable for patients who have a long-stay. The dose of 60 mg/d is suitable for patients who have a short-stay or need to achieve effects as quickly as possible. The dose of 90 mg/d is suitable for patients who need to be rescued instantly or whose airway is easy to be blocked by the plugs of sputum, and monitoring uric acid of patients during the airway humidification is necessary.
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Key words:
- Tracheotomy /
- Airway humidification /
- Ambroxol /
- Different doses
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