沐舒坦联合肺灌洗对重型颅脑损伤气管切开术后患者肺部感染的疗效  

Effect of mucosolvan combined with bronchoalveolar lavage on pulmonary infection of tracheostomy patients after severe traumatic brain injury

作　　者：刘康峰[1] 黄文娟[1] 马劲光[1] 蔡仁端[1] 肖华[1] 于海建[1] 

机构地区：[1]南方医科大学附属花都人民医院神经外科,广州510800

出　　处：《中华神经医学杂志》2011年第11期1156-1159,共4页Chinese Journal of Neuromedicine

基　　金：2011年度广州市医药卫生科技重点项目（201102A212027）

摘　　要：目的观察沐舒坦静脉注射联合纤支镜下肺灌洗对重型颅脑损伤气管切开术后患者肺部感染的疗效。方法将广州市花都区人民医院神经外科自2009年1月25日至2010年11月25日收治的42例重型颅脑损伤气管切开术后患者按随机数字表法分为联合治疗组（沐舒坦静脉注射±纤支镜下肺灌洗）和对照组（纤支镜下肺灌洗），每组各21例。气管切开术后第1、3、5、7天取患者支气管肺灌洗液做细胞学检查，并观察气管切开术后1月内患者肺部感染及控制情况、气管套管拔除例数。结果联合治疗组患者支气管肺灌洗液中白细胞数在气管切开术后第5、7天明显降低．多形核细胞数在第3、5、7天明显降低，与对照组比较差异均有统计学意义（P〈0．05）。联合治疗组患者气管切开术后1月内肺部感染例数（12例）、感染控制时间[（7．08±2．10）d]以及拔除气管套管例数（13例）与对照组[19例，（11．86±3．63）d，5例]比较差异均有统计学意义（P〈0．05）。结论沐舒坦静脉注射联合纤支镜下肺灌洗可减轻重型颅脑损伤气管切开术后患者早期气道炎症反应，对肺部感染防治及气道恢复较单纯肺灌洗疗效更明显。Objective To observe the effects of mucosolvan combined with bronchoalveolar lavage on pulmonary infection of tracheostomy patients after severe traumatic brain injury. Methods Forty-two patients were chosen in our study and divided randomly into combination therapy group （mucosolvan injection combined with bronchoalveolar lavage, n=21） and control group （bronchoalveolar lavage alone, n=21）. Their bronchoalveolar lavage fluid was examined cytologically. One month after tracheostomy, the pulmonary infection conditions of these patients and their control status were observed, and the number of patients performed removal of trachea cannula was calculated. Results Leucocyte count in the bronchoalveolar lavage fluid in combination therapy group was significantly reduced since the 5^th and 7^th d oftratment, and their polymorphocyte count was significantly reduced on the 3^th, 5^th and 7^th d of treatment as compared with those in the control group （P〈0.05）; significant differences were also noted between the 2 groups in the number of patients with pneumonia 1 month after tracheostomy, the days that patients＇ infections were controlled and the numbers of patients whose trachea cannula were removed （P〈0.05）. Conclusion Mucosolvan combined with bronchoalveolar lavage can reduce the early inflammation of the airway, and has more obvious therapeutic effect on pulmonary infection and recovery of airway than bronchoalveolar lavage alone.

关 键 词：沐舒坦 肺灌洗 颅脑损伤 气管切开 肺部感染 肺炎 

分 类 号：R473.6[医药卫生—护理学]