黄茂　　王笑咪　　郭微微

[摘要] 目的 研究鹽酸氨溴索在慢性阻塞性肺疾病临床治疗中的应用价值。 方法 回顾性分析2016年1月至2019年12月我院收治的慢性阻塞性肺疾病患者150例，按照治疗方法将其分为对照组和观察组，每组各75例。对照组行常规治疗，观察组则在对照组的基础上实施盐酸氨溴索开展治疗，比较两组治疗总有效率、动脉血气分析指标、症状消失时间、住院时间、呼吸功能指标及呼吸机相关肺炎发生率。 结果 观察组治疗总有效率显著高于对照组，差异有统计学意义（P<0.05）;治疗后，观察组OI显著高于对照组，而观察组Lac显著低于对照组，差异有统计学意义（P<0.05）;观察组症状消失时间、住院时间显著短于对照组，差异有统计学意义（P<0.05）;实施后，观察组PEEPi、气道阻力显著低于对照组，但观察组Cst 高于对照组，差异有统计学意义（P<0.05）;观察组呼吸机相关肺炎发生率低于对照组，差异有统计学意义（P<0.05）。 结论 对慢性阻塞性肺疾病实施盐酸氨溴索开展治疗简单有效，主要体现在治疗效果的提升、生活质量的提高上，具有积极改善患者预后、缩短住院时间的效果。

[关键词] 盐酸氨溴索;慢性阻塞性肺疾病;生活质量;呼吸功能指标

[中图分类号] R563.8          [文献标识码] A          [文章编号] 1673-9701（2021）13-0033-04

The application value of ambroxol hydrochloride in the clinical treatment of chronic obstructive pulmonary disease

HUANG Mao   WANG Xiaomi   GUO Weiwei

Department of Respiratory and Critical Care Medicine， Taizhou First People′s Hospital in Zhejiang Province， Taizhou   318000， China

[Abstract] Objective To study the application value of ambroxol hydrochloride in the clinical treatment of chronic obstructive pulmonary disease. Methods A retrospective analysis was performed on patients with chronic obstructive pulmonary disease（150 cases） admitted to our hospital from January 2016 to December 2019. The patients were divided into the control group and the observation group， with 75 cases in each group， according to the randomization method. The control group was received conventional treatment， and the observation group was treated with ambroxol hydrochloride based on the treatment of the control group. The total effective rate of treatment， arterial blood gas analysis indicators， symptom disappearance time， hospital stay， respiratory function indicators， and the incidence of ventilator-associated pneumonia were compared between the two groups. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group， with significant difference（P<0.05）. After the treatment， OI in the observation group was significantly higher than that in the control group， while Lac in the observation group was significantly lower than that in the control group，  with significant difference（P<0.05）. The symptoms disappearance time and hospital stay in the observation group were significantly shorter than those in the control group， with significant difference（P<0.05）. After the implementation， the PEEPi and airway resistance in the observation group were significantly lower than those in the control group， but the Cst in the observation group was higher than that in the control group， with significant difference（P<0.05）. The incidence of ventilator-related pneumonia in the observation group was lower than that in the control group， with significant difference（P<0.05）. Conclusion The ambroxol hydrochloride for the treatment of chronic obstructive pulmonary disease is simple and effective， mainly in the improvement of the treatment effect and the quality of life. It has the effect of actively improving the prognosis of patients and shortening the length of hospitalization.

[Key words] Ambroxol hydrochloride; Chronic obstructive pulmonary disease; Quality of life; Respiratory function index

慢性阻塞性肺疾病（Chronic obstructive pulmonary disease，COPD）在我國呈现出逐年上升趋势，且死亡率及致残率均有所上升，以反复呼吸道症状和持续气流受限为典型症状，病程呈进行性加剧，呼吸衰竭是COPD最严重的并发症，机械通气是COPD治疗方法，可使患者得到充足的氧合通气，缓解呼吸肌疲劳，但若长期治疗将诱发多种并发症，如呼吸机相关肺炎、气道黏液堆积、气道感染、全身性炎症反应等，导致治疗效果降低，加重患者家庭负担[1-3]。随着医疗科技的发展，临床出现多种不同治疗COPD的药物，均有一定效果，而氨溴索属于黏液溶解剂，可促进痰液的排出，可消除患者体内存在的炎症因子，其应用价值已获得临床诸多医师的认可，但由于缺乏相关报道，导致其应用受限[4-6]。本研究将盐酸氨溴索用于COPD临床治疗中，现将实施方法及结果进行总结，为临床治疗提供依据，现报道如下。……