气管插管非机械通气患者雾化吸入与肺部感染的临床研究  

Aerosol inhalation and pulmonary infection in patients taking tracheal intubation andnon-mechanical ventilation

作　　者：李银优[1] 周秀红[1] 张清[1] 钟谒玲 Li Yinyou;Zhou Xiuhong;Zhang Qing;Zhong Yeling(Department of Neurosurgery,Longgang District Central Hospital,Shenzhen 518116,China)

机构地区：[1]深圳市龙岗中心医院神经外科,深圳518116

出　　处：《国际医药卫生导报》2022年第23期3278-3281,共4页International Medicine and Health Guidance News

基　　金：深圳市龙岗科技创新局(LGKCYLWS2020017)。

摘　　要：目的探讨气管插管非机械通气患者雾化吸入与肺部感染的相关性。方法选择2020年1月至2021年3月深圳市龙岗中心医院神经外科收治的60例自发性脑出血并在入院24 h内均行气管插管术的患者为研究对象,随机数字表法分为A组和B组,各30例。A组平均年龄50.23岁,男27例,女3例;B组平均年龄51.20岁,男26例,女4例。A组人工鼻+充分补液基础上进行气道湿化,促进排痰使用沐舒坦30 mg生理盐水20 ml静脉注射Bid;B组在A组的基础上增加雾化吸入布地奈德1 mg+生理盐水10 ml Tid。比较两组患者呼吸频率、血氧饱和度(SPO_(2))、痰液量、临床肺部感染评分(CPIS)情况。采用t检验。结果两组患者入院时呼吸频率、SPO_(2)、痰液量、CPIS比较,差异均无统计学意义(均P>0.05)。入院72 h,A组痰液量(22.40±1.15)ml,B组(25.93±1.24)ml,差异有统计学意义(P<0.05);入院144 h,A组痰液量、CPIS(21.00±0.89)ml、(2.63±0.32)分,B组(25.00±0.98)ml、(4.33±0.38)分,差异均有统计学意义(均P<0.05)。结论雾化吸入增加或加重了患者肺部感染,气管插管非机械通气患者不建议雾化吸入预防或者治疗肺部感染。Objectives To explore the correlation between atomization inhalation and pulmonary infection in patients taking tracheal intubation and non-mechanical ventilation.Methods Sixty patients with intracerebral hemorrhage who took tracheal intubation at Department of Neurosurgery,Longgang District Central Hospital within 24 h after admission from January 2020 to June 2021 were selected,and were divided into group A and group B by the random number table method,with 30 cases in each group.There were 27 males and 3 females in group A who were averagely 50.23 years old.There were 26 males and 4 females in group B who were averagely 51.20 years old.Group A took airway humidification on the basis of artificial nose and full fluid replacement,and intravenously injected 30 mg mucosolvan and 20 ml normal saline for sputum excretion,Bid.Group B added 1 mg budesonide and 10 ml normal saline Tid on the basis of group A.The respiratory rates,oxygen saturations of blood(SPO_(2)),sputum volumes,and clinical pulmonary infection scores(CPIS)of the two groups were compared.t test was applied.Results There were no statistical differences in respiratory rate,SPO_(2),sputum volume,and CPIS between the two groups at admission(all P>0.05).Seventy-two hours after admission,the sputum volume was(22.40±1.15)ml in group A,and was(25.93±1.24)ml in group B,with a statistical difference(P<0.05).One hundred and forty-four hours after admission,the sputum volume and CPIS were(21.00±0.89)ml and(2.63±0.32)in group A,and was(25.00±0.98)ml and(4.33±0.38)in group B,with statistical differences(both P<0.05).Conclusions Atomization inhalation increases or aggravates the patients'pulmonary infection.It is not recommended to prevent or treat pulmonary infection in patients taking endotracheal intubation and non-mechanical ventilation.

关 键 词：雾化吸入 气管插管 肺部感染 CPIS 

分 类 号：R651.12[医药卫生—外科学] R563.1[医药卫生—临床医学]