高压氧治疗对重型颅脑损伤气管切开术后患者肺部感染的影响  

Hyperbaric oxygen for lung infection patients with severe brain injury and tracheotomy

作　　者：许立民[1] 孔磊[1] 肖泉[2] 王栋 刘若平[2] 俸道荣[1] 宋献丽[1] 黄剑平[1] 

机构地区：[1]广西壮族自治区人民医院高压氧科,南宁530021 [2]广西壮族自治区人民医院神经外科,南宁530021 [3]广西壮族自治区卫生监督所

出　　处：《中华物理医学与康复杂志》2011年第10期770-774,共5页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：广西壮族自治区医疗卫生自筹经费计划课题（Z2008069）

摘　　要：目的探讨重型颅脑损伤气管切开术后肺部感染的高压氧（HBO）和常压下吸氧管供氧治疗的近期治疗效果。方法选取符合入选标准的重型颅脑损伤气管切开术后肺部感染患者60例，按随机分层设计分为高压氧组和常规组，每组30例，两组患者均给予吸氧、降颅压、护脑、手术、抗生素及对症支持治疗。常规组在常压下经气管套管采用一次性吸氧管给氧治疗，高压氧组采用我科自创吸氧连接装置进行高压氧治疗。观察两组患者体温、咳嗽咳痰、肺部呼吸音、白细胞总数及分类等恢复正常的时间，并进行比较。结果高压氧组体温正常、咳嗽咳痰好转、肺部呼吸音清晰、白细胞总数及分类正常的时间明显短于常规组，组间比较差异有统计学意义（P〈0．01）。结论高压氧对重型颅脑损伤气管切开肺部感染患者有排痰、化痰作用，利于肺部感染的控制。Objective To compare the effectiveness of hyperbaric oxygen （HBO） therapy and normal pressure oxygen inhalation for lung infection in patients with severe brain injury and tracheotomy. Methods Sixty lung infection patients with severe brain injury and traeheotomy were stratified by age and Glasgow coma scale （GCS） score into an HBO group （30） and a conventional therapy group （30）. Both groups were given treatments to reduce intracranial hypertension and protect the brain, surgery, antibiotics, and symptomatic and support therapy. In the conventional group the patients received oxygen therapy at normal oxygen pressure by tracheal eannula. In the HBO group, the patients received HBO therapy through self-made oxygen devices by the authors. The body temperature, cough and expectoration, respiratory sounds and white blood cell （WBC） count were compared between the groups. Results There were statistically significant differences in body temperature, cough and expectoration, respiratory sounds and the normalized time for the count and classification of WBC between the groups. Conclusion HBO had good treatment effectiveness for excretion and expectorant in lung infection patients with severe brain injury and tracheotomy.

关 键 词：高压氧 颅脑损伤 气管切开术 肺水肿 神经源性 肺部感染 

分 类 号：R473.6[医药卫生—护理学]