早期气管切开术联合复方异丙托溴铵防治老年重症颅脑损伤患者肺部感染的临床效果  

Clinical effect of early tracheotomy combined with compound isopropyl bromide in prevention of pulmonary infection of elderly severe craniocerebral injury patients

作　　者：苗林[1] 夏吉勇[1] 李志强[1] 丛文凯 任雅盼 MIAO Lin;XIA Ji-yong;LI Zhi-qiang(Department of Neurosurgery, Beijing Mentougou District Hospital, Beijing 102300, China)

机构地区：[1]北京市门头沟区医院神经外科,102300

出　　处：《临床合理用药杂志》2018年第6期1-2,5,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨早期气管切开术联合复方异丙托溴铵防治老年重症颅脑损伤肺部感染的临床效果。方法选取北京市门头沟区医院2015年1月—2017年1月收治的老年重症颅脑损伤患者92例,采用随机数字表法将其分为对照组与研究组,每组46例。对照组患者予以气管切开术联合雾化吸入法,研究组患者予以常规气管切开术联合复方异丙托溴铵,比较两组患者治疗期间肺部感染发生率、症状控制时间和治疗总时间、治疗前后呼吸功能相关指标[氧合指数、血氧饱和度(SaO_2)、血二氧化碳分压(PaCO_2)、血氧分压(PaO_2)]、临床疗效及治疗满意度。结果研究组治疗期间肺部感染发生率低于对照组,症状控制时间和治疗总时间均短于对照组(P<0.05)。治疗前,两组患者氧合指数、SaO_2、PaCO_2及PaO_2比较,差异无统计学意义(P>0.05);治疗后,研究组患者氧合指数、SaO_2及PaO_2高于对照组,PaCO_2低于对照组(P<0.05)。研究组治疗总有效率、治疗满意度高于对照组(P<0.05)。结论老年重症颅脑损伤患者应用早期气管切开术联合复方异丙托溴铵可有效预防肺部感染。Objective To study the clinical effect of early tracheotomy combined with compound isopropyl bromide in prevention of pulmonary infection of elderly severe craniocerebral injury patients. Methods A total of 92 cases of elderly severe craniocerebral injury patients were selected form January 2015 to January 2017 in Beijing Mentougou District Hospital,which were divided into control group and study group according to random number table,46 cases in each group. The control group was given early tracheotomy combined with spray inhalation,the study group was treated with early tracheotomy combined with compound isopropyl bromide. The incidence of pulmonary infection,symptom control time and total treatment time,respiratory function related indicators（ oxygenation index,SaO2,PaCO2,PaO2） before and after treatment,clinical effect and treatment satisfaction were compared between the two groups. Results The study group of pulmonary infection rate was lower than control group,symptom control time and total treatment time were shorter than control group（ P〈0. 05）. Beofre treatment,no significant differences of oxygenation index,SaO2,PaCO2 or PaO2 was found between the two groups（ P〉0. 05）; after treatment,the study group of oxygenation index,SaO2,PaO2 were higher than control group,PaCO2 was lower than control group（ P〈0. 05）. The study group of total effective rate and treatment satisfaction were higher than control group（ P〈0. 05）. Conclusion Early tracheotomy combined with compound isopropyl bromide can effectively prevent the pulmonary infection of elderly severe craniocerebral injury patients.

关 键 词：颅脑损伤 异丙托溴铵 肺部感染 预防 

分 类 号：R563.1[医药卫生—呼吸系统] R651.15[医药卫生—内科学]