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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

23卷

期数:

2017年03期

页码:

242-245

栏目:

临床医学

出版日期:

2017-05-18

文章信息/Info

Title:

Perioperative clinical evaluation of budesonide combined with terbutaline by nebulization in the treatment of gastroesophageal reflux disease with hiatal hernia

文章编号:

1006-8147(2017)03-0242-04

作者:

史亚洲;  宋世辉;  吕 朋;  李家腾

(天津医科大学总医院胸外科,天津 300052)

Author(s):

SHI Ya-zhou;  SONG Shi-hui;  Lv-Peng;  LI Jia-teng

(Department of Cardiothoracic Surgery, General Hospital, Tianjin Medical University Tianjin 300052, China)

关键词:

胃食管反流病; 食管裂孔疝; 布地奈德; 特布他林; 围手术期

Keywords:

gastroesophageal reflux disease; hiatal hernia; budesonide;  terbutaline; perioperative period

分类号:

R655

DOI:

-

文献标志码:

A

摘要:

目的：研究布地奈德联合特布他林雾化吸入对胃食管反流病合并食管裂孔疝患者在围手术期的临床疗效。方法：选择入院需行腹腔镜下食管裂孔疝修补+胃底折叠术患者50例，均伴有反酸、烧心及不同程度呼吸道症状，将患者随机分为试验组与对照组，围手术期术前3 d至术后5 d试验组予布地奈德联合特布他林雾化吸入治疗，对照组应用安慰剂，术前第3天及术后第5天行肺功能检查并记录指标[1秒内用力呼气容积（FEV1）、最大自主通气量（MVV）、用力肺活量（FVC）、1秒内用力呼气容积占用力肺活量比值（FEV1/FVC%）],围手术期监测患者动脉血气分析[血氧饱和度(SaO₂) 、二氧化碳分压(PaCO₂)、血氧分压(PaO₂)、动脉乳酸（Lac)]，术后评价临床疗效。结果：试验组术后肺功能、血气分析优于对照组；试验组反酸、咳嗽咳痰、胸闷等不适症状较对照组明显缓解，临床疗效优于对照组，差异有统计学意义（P＜0.05）。结论：胃食管反流病合并食管裂孔疝患者在围手术期间应用布地奈德联合特布他林可以有效改善患者围手术期肺功能、动脉血氧合指标, 增加手术疗效以及提高患者生活质量。

Abstract:

Objective: To investigate the clinical effect of budesonide combined with terbutaline by inhalation in the treatment of gastroesophageal reflux disease with hiatal hernia in the perioperative period .Methods: Fifty cases of patients in hospital were selected ,who underwent laparoscopic hiatal hernioraphy plus fundoplication. They were associated with acid reflux, heartburn and varying degrees of respiratory symptoms. The patients were randomly divided into experimental and control groups. In the perioperative period--from three days before the surgery to five days after, the experimental group was treated with budesonide combined with terbutaline by nebulization, while placebo was used in the control group. On the third day before and the fifth day after the operation, all of the patients completed pulmonary function testing and indicators [forced expiratory volume in one second (FEV1), maximal voluntary ventilation (MVV), forced vital capacity (FVC), forced expiratory volume occupied vital capacity ratio within 1 second( FEV1 / FVC%)] were recorded. Arterial blood gas was detected in the perioperative period [oxygen saturation (SaO₂), carbon dioxide partial pressure (PaCO₂), blood oxygen pressure (PaO₂), arterial lactate (Lac)], the clinical efficacy after the operation was evaluated . Results: The lung function , blood gas condition in the experimential group were better than those in the control group; we found that acid reflux, cough, sputum, chest tightness and other symptoms in the experimental group were significantly alleviated compared with those in the control group. The clinical effect was better than that in the control group, and the difference was statistically significant (P <0.05). Conclusion: The clinical efficacy of budesonide combined with terbutaline by inhalation in the treatment of gastroesophageal reflux disease with hiatal hernia in the perioperative period is marked, which can improve pulmonary function and arterial oxygenation index, and enhance the curative effect and the life quality of the patients.

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相似文献/References:

[1]王赜煜,李 倩,李熳,等.3 956例反流性食管炎临床特征分析[J].天津医科大学学报,2017,23(01):65.
　WANG Ze-yu,LI Qian,LI Man,et al.Analysis of clinical characteristics of reflux esophagitis in 3 956 patients[J].Journal of Tianjin Medical University,2017,23(03):65.
[2]林翠玲,宋世辉,崔元涛,等.快速康复外科理念在胃食管反流病患者术中的临床应用[J].天津医科大学学报,2018,24(03):240.

备注/Memo

备注/Memo:

作者简介 史亚洲（1989-），男，硕士在读，研究方向：胸部外科微创技术与胸部肿瘤基础研究；通信作者：宋世辉，E-mail: xwsongshihui@126.com。

常用功能

更新日期/Last Update: 2017-05-18