布地奈德联合异丙托溴胺雾化吸入对老年肺癌肺叶切除患者肺功能保护的研究

目的：研究围手术期布地奈德联合异丙托溴胺雾化吸入保护老年肺叶切除患者肺功能的应用价值。方法：选取112例接受肺叶切除术的老年患者作为临床研究资料,按照随机对照原则将入组患者分为研究组58例和对照组54例,研究组患者围手术期给予布地奈德联合异丙托溴胺雾化吸入治疗并加常规基础治疗（氧疗、辅助排痰、呼吸康复训练）,对照组患者接受常规雾化治疗加常规基础治疗,观察并对照两组患者入院时、术前及术后1、3个月的肺功能指标。结果：研究组经过吸入治疗后术前每分钟最大通气量（MVV）、第一秒用力呼气量（FEV1）、用力肺活量（FVC）及动脉氧分压（PaO2）均较入院时显著提高,两组术后1、3个月的MVV、FEV1、FVC及PaO2均明显低于术前,但研究组术后1、3个月各指标均明显高于对照组,差异均有统计学意义（P〈0.05）。研究组术后1个月与术前差值ΔMVV、ΔFEV1、ΔFVC显著低于对照组（P〈0.05）,研究组术后白介素-6、8（IL-6、IL-8）水平显著低于术前和对照组术后（P〈0.05）,对照组手术前后IL-6和IL-8水平无统计学差异。两组患者均未发现严重不良反应及并发症。结论：围手术期布地奈德联合异丙托溴胺雾化吸入可以有效保护老年肺叶切除患者的肺功能,值得推广。

Protective effect of budesonide combined with ipratropium bromide inhalation on lung func- tion of elderly patients with lung Iobectomy

Objective：To explore protective effect of budesonide combined with ipratropium bromide inhalation on lung function of elderly patients with lung lobectomy.Methods：A total of 112 elderly patients underwent lobectomy were selected,and were divided into control group with 58 cases and study group with 54 cases.Patients in study group were treated with perioperative budesonide combined with ipratropium bromide inhalation plus conventional basic therapy（oxygen therapy,assisted expectoration,respiratory rehabilitation）,while patients in control group had conventional therapy plus conventional basic atomization therapy.Pulmonary function when they were admitted,after surgery,1,3months after surgery were observed.Results：Preoperative MVV,FEV1,FVC and PaO2 in study group were significantly improved after inhalation therapy（P〈0.05）.MVV,FEV1,FVC and PaO2 were significantly decreased 1and 3months after surgery（P〈0.05）.However,MVV,FEV1,FVC and PaO2 of study group were significantly higher than those of control group（P〈0.05）.MVV,FEV1,FVC of study group were significantly lower than those of control group（P〈0.05）.IL-6and IL-8levels were significantly decreased after surgery（P〈0.05）.These levels of study group were also significantly lower than those of control group（P〈0.05）.There were no significant changes in IL-6or IL-8levels after surgery in study group.No serious adverse reactions or complications occurred in two groups.Conclusion：Perioperative budesonide combined with ipratropium bromide inhalation can effectively protect lung function in elderly patients with lobectomy.