改良叩背法辅助替考拉宁治疗重型颅脑损伤合并MRSA肺炎的效果评价  

Evaluation of therapeutic effect of the modified percussion-on-back method combined with teicoplanin in patients with severe traumatic brain injury complicated with MRSA pneumonia

作　　者：侯岩 方治军 孙智宏[1] 张影 Hou Yan;Fang Zhi-jun;Sun Zhi-hong;Zhang Ying(Department of Neurosurgery,Daxing District People’s Hospital,Beijing 102600)

机构地区：[1]北京市大兴区人民医院神经外科,北京102600

出　　处：《中国抗生素杂志》2022年第12期1342-1344,I0001,共4页Chinese Journal of Antibiotics

摘　　要：目的叩背辅助排痰是重症患者的重要辅助治疗手段,探讨临床护理的改良叩背法辅助糖肽类抗生素替考拉宁在重型颅脑损伤(severe traumatic brain injury,sTBI)合并医院获得性耐甲氧西林金黄色葡萄球菌(methicillin resistant Staphylococcus aureus,MRSA)肺炎患者的临床治疗效果。方法选择2018年1月—2021年1月在医院神经重症医学科进行治疗的88例sTBI合并医院获得性MRSA肺炎的患者,随机分为观察组和对照组,各44例。观察组给予替考拉宁抗感染联合改良叩背法治疗肺部感染,对照组给予替考拉宁并实行基础护理措施治疗肺部感染。治疗前及1周后比较两组患者的血气指标、临床指标和护理质量满意度。结果在替考拉宁抗感染治疗sTBI合并医院获得性MRSA肺炎的患者,辅助用改良叩背法排痰后肺功能改善明显,表现为观察组的24 h排痰量、PaO_(2)和SaO_(2)显著高于对照组(P=0);而PaCO_(2)、每日咳嗽次数、肺部感染持续时间以及住院时间均显著低于对照组(P=0);观察组患者家属对护理的满意度也明显高于对照组。结论改良叩背法辅助糖肽类抗生素替考拉宁治疗sTBI合并医院获得性MRSA肺炎患者可有效改善患者的血气指标,缓解肺部感染症状,缩短病程,提高患者家属的护理满意度。Objective To explore the clinical effect of glycopeptide antibiotic teicoplanin combined with the modified percussion-on-back method in patients with severe traumatic brain injury(sTBI)complicated with hospital acquired methicillin resistant Staphylococcus aureus(MRSA)pneumonia.Methods Eighty-eight patients with sTBI complicated with hospital acquired MRSA pneumonia treated in the Department of Neurocritical Medicine of the hospital from January 2018 to January 2021 were randomly divided into the observation group and the control group,with 44 cases in each group.The observation group was given teicoplanin combined with the modified percussion-on-back method to treat MRSA pneumonia,and the control group was given teicoplanin and implemented basic nursing measures to treat pulmonary MRSA infection.The blood gas index,clinical index,and nursing quality satisfaction of the two groups were compared before and one week after treatment and nursing.Results In patients with STBI complicated with hospital acquired MRSA pneumonia treated with teicoplanin combined with the modified percussion-on-back method to sputum excretion,the pulmonary function was significantly improved.The 24-hour sputum excretion volume,PaO_(2),and SaO_(2) in the observation group were significantly higher than those in the control group(P=0),while PaCO_(2),cough times per day,duration of pulmonary infection,and hospital stay in the observation group were significantly lower than those in the control group(P=0).In addition,the satisfaction of family members of patients in the observation group was also significantly higher than that in the control group.Conclusion The modified percussion-on-back method combined with glycopeptide antibiotic teicoplanin in the treatment of STBI patients with hospital acquired MRSA pneumonia can effectively improve the blood gas indexes of patients,alleviate the symptoms of pulmonary infection,shorten the course of disease,and improve the nursing satisfaction of patients'families.

关 键 词：重型颅脑损伤 医院获得性肺炎 替考拉宁 改良叩背法 MRSA 

分 类 号：R4[医药卫生—临床医学]