气管切开导管气囊上滞留物引流对防治重型颅脑损伤后肺部感染的影响  

Effect of subglottic secretion drainage after tracheotomy on prevent pulmonary infection in severe brain injury

作　　者：廖圣芳[1] 王玉差[1] 陈汉民[1] 黄国河[1] 管定国[1] 余锦刚[1] 

机构地区：[1]解放军第180医院脑外科,福建泉州362000

出　　处：《临床军医杂志》2011年第1期64-66,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨气管切开导管气囊上滞留物引流对重型颅脑损伤后肺部感染防治的临床价值。方法选择GCS 3～8分重型颅脑损伤需行气管切开患者90例,随机分为实验组(45例)和对照组(45例),气管切开时,实验组选择可冲洗气管套管,对照组选择常规气管套管。实验组定期对气囊上滞留物冲洗引流,对照组未予气囊上滞留物冲洗引流。所有患者其他治疗措施均基本相同。结果实验组肺部感染的发病率为35.56%,对照组肺部感染的发病率为66.67%。肺部感染患者气囊上滞留物与下呼吸道优势菌符合率为76.09%。结论气囊上滞留物病原菌的移行是导致肺部感染的重要原因之一,引流气囊上滞留物能有效防治重型颅脑损伤后并发肺部感染。Objective To explore the clinical evaluation of subglottic secretion drainage for prevent pulmonary infection in severe brain injury.Methods 90 severe brain injury patients（GCS3~8） were randomly assigned in to 2 groups： trial group（45 cases） and control group（45 cases）.Trial group was treated by irrigative tracheotomy tube and received aspiration of subglottic secretion.control group was treated by Conventional tracheotomy tube and received general care.Results The incidence of pulmonary infection was 35.56% in trial group and 66.67% in control group.The same rate of predominant flora in subglottic secretion and lower respiratory tract secretion was 76.09% in patients of pulmonary infection.Conclusion Transposition of the pathologic bacteria in subglottic secretion is the main factors of pulmonary infection.Subglottic secretion drainage can effectively prevent pulmonary infection in patients with severe brain injury.

关 键 词：重型颅脑损伤 气囊上滞留物 感染 肺 

分 类 号：R651.15[医药卫生—外科学]