氨溴索雾化吸入对脊柱手术患者肺部感染的预防控制效果研究  

Effect of aerosol inhalation of ambroxol on prevention and control of pulmonary infections in patients undergoing spinal surgery

作　　者：申翠香[1] 马红霞[1] 李学勤[2] 常晓华[3] 王萱莹 

机构地区：[1]滨州市人民医院手术室,山东滨州256610 [2]滨州市人民医院耳鼻咽喉,山东滨州256610 [3]滨州市人民医院感染科,山东滨州256610

出　　处：《中华医院感染学杂志》2016年第9期2082-2084,共3页Chinese Journal of Nosocomiology

基　　金：山东省自然科学基金资助项目(ZR2009CL018)

摘　　要：目的研究氨溴索雾化吸入对脊柱手术后肺部感染的预防控制效果,降低其感染率。方法选取医院2013年1月-2015年6月接受脊柱手术的患者400例,随机分为对照组和试验组,每组各200例,对照组患者给予传统雾化液,试验组患者在对照组的基础上雾化吸入氨溴索;比较两组患者的肺部感染率、疗效、临床症状消失时间、住院时间和复发率;采用SPSS 20.0软件进行统计分析。结果对照组肺部感染率为8.00%,试验组感染率为1.50%,两组差异有统计学意义(P<0.05);19例接受脊柱手术后发生肺部感染患者的送检标本中共分离出19株病原菌,其中革兰阴性菌占68.42%,革兰阳性菌占26.32%,真菌占5.26%;革兰阴性菌对氨苄西林、左氧氟沙星、头孢唑林的耐药性较高,对妥布霉素、哌拉西林/他唑巴坦、美罗培南的耐药性较差;对照组患者的治疗有效率为92.00%,试验组为98.50%,差异有统计学意义(P<0.05);试验组患者肺部啰音、咳嗽、呼吸困难、憋喘等临床症状的消失时间及住院时间均少于对照组,差异有统计学意义(P<0.05);对照组患者复发率为25.00%,试验组无复发,差异有统计学意义(P<0.05)。结论氨溴索雾化吸入能降低脊柱手术患者的肺部感染率、复发率,提高疗效,缩短临床症状消失时间和住院时间。OBJECTIVE To observe the effect of aerosol inhalation of ambroxol on prevention and control of postoperative pulmonary infections in patients undergoing spinal surgery so as to reduce the infection rate.METHODS A total of 400 patients who underwent the spinal surgery from Jan 2013 to Jun 2015 were enrolled in the study and randomly divided into the control group and the experimental group,with 200 cases in each.The control group was treated with conventional atomized liquid,while the experimental group was given the aerosol inhalation of ambroxol on basis of the treatment of the control group.The incidence of pulmonary infections,efficacy,time of disappearance of clinical symptoms,length of hospital stay,and recurrence rates were observed and compared between the two groups of patients,and the statistical analysis was performed with the use of SPSS 20.0software.RESULTS The incidence rate of pulmonary infections was 8.00%in the control group,1.50%in the experimental group,and there was significant difference between the two groups（P〈0.05）.Totally 19 strains of pathogenic bacteria were isolated from the 19 patients with postoperative pulmonary infections,of which 68.42% were gramnegative bacteria,26.32% were gram-positive bacteria,and 5.26% were fungi.The gram-negative bacteria were highly resistant to ampicillin,levofloxacin,and cefazolin,while the drug resistance rates to tobramycin,piperacillin-tazobactam,and meropenem were low.The effective rate of treatment of the control group was 92.00%,the experimental group 98.50%,and there was significant difference（P〈0.05）.The time of disappearance of clinical symptoms such as pulmonary rales,cough,dyspnea,and suppress wheezing and the length of hospital stay were shorter in the experimental group than in the control group,and there was significant difference（P〈0.05）.The recurrence rate was 25.00%in the control group,0in the experimental group,and there was significant difference（P〈0.05）.CONCLUSIONThe aerosol inhalation of ambroxol can reduce the

关 键 词：氨溴索 脊柱手术 肺部感染 雾化吸入 预防控制效果 

分 类 号：R681.5[医药卫生—骨科学]