Efficacy of high-dose ambroxol combined with imipenem in treatment of elderly patients with severe pneumonia treated by mechanical ventilation
Objective To investigate the efficacy and safety of high-dose ambroxol combined with imipenem in the treatment of elderly patients with severe pneumonia treated by mechanical ventilation.Methods A total of 86 elderly(≥80 years old)patients with severe pneumonia admitted to ICU of Characteristics Medical Center of PLA Rocket Force from June 2019 to June 2023 were divid-ed into two groups by random number table method,they were divided into two groups.The control group included 40 patients who re-ceived conventional-dose ambroxol combined with imipenem treatment,while the study group included 46 patients who received high-dose ambroxol[15 mg/(kg·d)]combined with imipenem treatment.The efficacy of the two groups was compared after treatment,in-cluding lung imaging,duration of mechanical ventilation,length of ICU stay.APACHE Ⅱ,SOFA,CPIS,changes in inflammatory factors and adverse reactions.Results Compared with the control group,the duration of mechanical ventilation of the study group was shorter[(8.15±1.31)d vs.(7.13±1.53)d,P<0.05],disappearance time of shadow on chest radiograph was faster[(7.80±1.02)d vs.(6.61±0.97)d,P<0.05].The duration of ICU stay was shorter[(16.25±1.78)d vs.(14.37±2.15)d,P<0.05],and the le-sion absorption rate was higher[(65.95±7.73)%vs.(78.96±9.11)%,P<0.05].After treatment,APACHE Ⅱ[(7.17±1.07)vs.(8.25±1.12),P<0.05],SOFA[(3.15±0.51)vs.(4.21±0.96),P<0.05],CPIS[(3.18±0.89)vs.(3.80±0.75),P<0.05],PCT[(0.16±0.07)μg/L vs.(0.25±0.12)μg/L,P<0.05],CRP[(5.15±3.11)mg/L vs.(8.51±2.96)mg/L,P<0.05],IL-6[(15.28±9.89)ng/L vs.(25.20±1.75)ng/L,P<0.05]of the study group decreased faster.There was no significant difference in the incidence of adverse reactions between the two groups during the observation period(P>0.05).Conclusions High-dose ambroxol combined with imipenem in the treatment of elderly patients with severe pneumonia treated by mechanical ventilation can shorten the duration of mechanical ventilation and ICU stay,and the safety is good.
severe pneumoniamechanical ventilationhigh-dose ambroxolimipeneminflammatory factor
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