复方异丙托溴铵雾化联合氨溴索静注治疗老年颅脑外伤气管切开患者的疗效观察  

Clinical efficacy of compound Ipratropium bromide atomization inhalation combined with Ambroxol intravenous treatment in traumatic brain injury patients with tracheotomy

作　　者：刘海生[1] 郭强[1] 

机构地区：[1]江苏省睢宁县人民医院ICU,221200

出　　处：《中华老年医学杂志》2016年第7期740-742,共3页Chinese Journal of Geriatrics

摘　　要：目的探讨复方异丙托溴铵雾化联合氨溴索静注在老年颅脑外伤气管切开患者中的应用价值。方法本文选取2014年4月至2025年4月来我院进行治疗的58例行气管切开术的老年颅脑外伤患者，随机分成观察组与对照组，对照组采用氨溴索静注进行治疗，观察组采用复方异丙托溴铵雾化联合氨溴索静注治疗，比较两组患者的肺部感染时间、气管切开置管时间、气道黏膜出血等并发症的发生情况以及患者的3d、7d、14d痰培养阳性情况。结果观察组患者的肺部感染时间和气管切开置管时间分别为（16．8±7．2）d和（19．0±5．9）d，均明显低于对照组的（24．5±14．1）d和（27．4±6．5）d，差异有统计学意义（P（O．05）；观察组患者的气道黏膜出血、刺激性咳嗽以及痰痂形成的发生率分别为10．3％、13．8％和13．8％，明显低于对照组的24．1％、27．6％和31．0％，差异具有统计学意义（P〈0．05）；观察组在治疗3d的痰培养阳性率为58．6％，与对照组的62．1％相比，差异无统计学意义。观察组患者在治疗5d、7d的痰培养阳性率分别为48．3％和34．5％，与对照组的55．2％和51．7％相比，差异具有统计学意义（P〈0．05）。结论复方异丙托溴铵雾化联合氨溴索静注治疗老年颅脑外伤气管切开患者的临床疗效显著，不良反应降低，值得临床推广与应用。Objective To investigate the clinical value of compound ipratropium bromide atomization inhalation combined with ambroxol intravenous treatment in traumatic brain injury patients with tracheotomy. Methods Totally 58 elderly patients undergoing tracheotomy for traumatic brain injury admitted to our hospital from April 2014 to April 2015 were selected, and they were randomly divided into the observation group and the control group. The control group was treated with a pure ambroxol intravenous injection, and the observation group was treated with compound Ipratropium bromide atomization inhalation combined with Ambroxol intravenous treatment. Pulmonary infection time, the indwelling time for tracheotomy tube, the incidences of airway mucosal bleeding and other complications and the positive rate of sputum culture at 3, 7, 14 days after treatment were compared between the two groups. Results Pulmonary infection time and the indwelling time for tracheotomy tube were shorter in the observation group than in the control group （（16.8 ±7.2） d vs. （24.5±14.1） d, （19.0±5.9） d vs. （27.4±6.5） d, both P〈0.05]. The incidences of airway mucosa bleeding, irritable cough and sputum crust were lower in the observation group than in the control group （10. 3% vs. 24. 1%, 13. 8% vs. 27. 6%, and 13.8% vs. 31.0%, all P〈0.05）. The positive rate of sputum culture at 3 days after treatment had no significant difference between the two group （58.6% vs. 62.1%, P〉0.05）. The positive rate of sputum culture at 5 and 7 days after treatment were lower in the observation group than in the control group （48.3% vs. 55.2%, 34.5% vs. 51.7%, P 〈 0.05）. Conclusions The compound Ipratropium bromide atomization inhalation combined with Amhroxol intravenous treatment versus a pure Amhroxol intravenous treatment has a significant clinical efficacy in elderly traumatic brain injury patients with tracheotomy, and it can reduce the incidence of adverse reactions, which is worthy of clinical application.

关 键 词：胆碱能拮抗剂 氨溴索 颅脑损伤 

分 类 号：R651.15[医药卫生—外科学] R653[医药卫生—临床医学]