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目的研究术前雾化吸入在呼吸道感染高风险食管癌手术患者当中的应用价值;方法选取拟定实施食管癌手术并存在呼吸道感染较高风险的患者106例,随机分为试验组(n=59)和对照组(n=47),试验组术前行3-5日的盐酸氨溴索联合异丙托溴铵雾化吸入治疗,同时行呼吸功能锻炼,对照组仅行呼吸功能锻炼,两组患者术后治疗方案相同;比较两组患者术后肺部感染、肺不张、肺水肿、呼吸衰竭、死亡等并发症的发生情况;结果试验组患者术后发生肺部感染者3例(3/59),无肺不张发生,对照组肺部感染者9例(9/47),肺不张者4例(4/47),两组比较差异有统计学意义(P<0.05)。两组患者间肺水肿、呼吸衰竭、死亡等并发症的对比无统计学意义(P>0.05)。结论对于呼吸道感染高风险人群,在实施食管癌手术前行雾化吸入治疗可降低患者术后发生肺炎、肺不张的风险,值得临床推广。
Objective To investigate the value of preoperative nebulization inhalation in patients with esophageal cancer who are at high risk for respiratory tract infection. Methods Sixty-six patients with esophageal cancer who were at higher risk of respiratory tract infection were enrolled in the study. They were randomly divided into experimental group (n = 59) And control group (n = 47). In the experimental group, ambroxol hydrochloride combined with ipratropium bromide was used for 3-5 days before inhalation. At the same time, the patients in the experimental group were given respiratory functional exercise while the control group only performed respiratory functional exercise. The two groups The postoperative patients were treated with the same treatment regimen. The incidence of postoperative pulmonary infection, atelectasis, pulmonary edema, respiratory failure and death were compared between the two groups. Results In the experimental group, 3 patients (3 / 59). No pulmonary atelectasis occurred in 9 cases (9/47) and 4 cases (47 cases) of pulmonary infection in control group. There was significant difference between the two groups (P <0.05). There was no significant difference in the complication of pulmonary edema, respiratory failure and death between the two groups (P> 0.05). Conclusion For patients with high risk of respiratory tract infection, aerosol inhalation therapy before esophageal cancer operation can reduce the risk of postoperative pneumonia and atelectasis, which is worthy of clinical promotion.