乙酰半胱氨酸雾化联合肺泡灌洗治疗胸科术后肺不张的临床效果

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Abstract Objective To investigate the curative effect of applying inhaled N-acetylcysteine (NAC) combined with fiberoptic bronchial alveolar lavageon patients with atelectasis after thoracic surgery. Methods A retrospective analysis was performed in 60 patients with atelectasis after operation needing mechanical ventilation. They were treated in our hospital from January 2015 to May 2019. According to different treatments, all participants were divided into the control group (n=30) and treatment group (n=30). In the control group, the patients were treated with aseptic injectable water for both the atomized inhalation and lavage. In the treatment group, the patients were treated with both NAC for atomized inhalation and NAC diluent for lavage. The changes of white blood cells (WBC), procalcitonin (PCT), oxygenation index (OI), oxygen partial pressure (PaO2) and carbon dioxide partial pressure (PaCO2) were measured before treatment and at the first day, third day and seventh day after treatment. The disappearance time of the lung rales and the time used for mechanical ventilation were compared. Results At the first day, third day and seventh day after treatment, the OI and PaO2 of patients in the two groups were higher than those before treatment, and the differences were statistically significant (P＜0.05). The OI and PaO2 in the treatment group at the third day and seventh day after treatment were higher than those in the control group, with statistically significant differences (P＜0.05). The PaCO2 at the first day, third day and seventh day after treatment of the two groups were lower than those before treatment, and the differences were statistically significant (P＜0.05). At the first day, third day and seventh day after treatment, there were no significant difference in PaCO2 between the two groups (P＞0.05). The PCT at the third day and seventh day after treatment in the treatment group were lower than those in the control group, and the differences were statistically significant (P＜0.05). There were no significant differences in WBC at the third day and seventh day after treatment between the two groups (P＞0.05). The disappearance time of the lung rales and the time used for mechanical ventilation in the treatment group were shorter than those in the control group, with statistically significant differences (P＜0.05). Conclusion The application of NAC for alveolar lavage can improve the functions of lung ventilation and breathing in patients with atelectasis after thoracic surgery, and control the symptoms of pulmonary infection, which is beneficial for patients.

Key words： Post-thoracic surgery Atelectasis Alveolar lavage N-acetylcysteine

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