布地奈德治疗重型颅脑损伤合并肺部感染的临床研究  

Clinical study of budesonide in the treatment of severe craniocerebral injury complicatedwith pulmonary infection

作　　者：韩庆亮 杜康 曹勇[2] 刘彪[2] 谢磊[2] 郑慧军[2] HAN Qingliang;DU Kang;CAO Yong;LIU Biao;XIE Lei;ZHENG Huijun(Second School of Clinical Medicine,Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China;Department of Neurosurgery,the Second Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China)

机构地区：[1]河南中医药大学第二临床医学院,郑州450000 [2]河南中医药大学第二附属医院神经外科,郑州450000

出　　处：《重庆医学》2022年第S02期37-40,共4页Chongqing medicine

基　　金：白求恩医学科学研究基金项目(SCZ420AN)。

摘　　要：目的观察布地奈德雾化治疗重型颅脑损伤合并肺部感染的临床疗效,并探讨其对患者外周血降钙素原(PCT)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及血气指标的影响。方法选取2019年7月至2021年10月河南中医药大学第二附属医院收治的重型颅脑损伤合并肺部感染患者50例,随机分为观察组和对照组,每组25例。对照组给予硫酸特布他林雾化吸入治疗,观察组在硫酸特布他林雾化吸入治疗基础上加用布地奈德雾化吸入治疗,连续治疗14 d后比较两组患者临床疗效,以及治疗前后PCT、CRP、TNF-α、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))、动脉血二氧化碳分压(PaCO_(2))水平等。结果观察组患者总有效率,以及治疗后SaO_(2)、PaO_(2)水平,格拉斯哥昏迷评分均明显高于对照组,治疗后PCT、CRP、TNF-α、PaCO_(2)水平均明显低于对照组,差异均有统计学意义(P<0.05)。结论雾化吸入布地奈德可减轻重型颅脑损伤合并肺部感染患者炎性反应,从而缓解其临床症状,改善呼吸功能,减轻继发性脑损伤。Objective To observe the clinical effect of budesonide atomization in the treatment of severe craniocerebral injury with pulmonary infection,and to explore its effect on procalcitonin(PCT),C-reactive protein(CRP)and tumor necrosis factor(TNF)in peripheral blood of patients-α(TNF-α)And blood gas index.Methods From July 2019 to October 2021,50 patients with lung infection after tracheotomy in early stage of severe brain injury were included in the Second Affiliated Hospital of Henan University of traditional Chinese medicine.They were randomly divided into the control group and the treatment group with 25 cases each.The control group was treated with terbutaline sulfate atomization inhalation,and the treatment group was treated with budesonide atomization inhalation on the basis of the control group.After 14 days of continuous treatment,the clinical efficacy and PCT,CRP and TNF before and after treatment were compared between the two groups-α、Arterial oxygen partial pressure(PaO_(2)),blood oxygen saturation(SaO_(2))and carbon dioxide partial pressure(PaCO_(2)).Results After 14 days of treatment,The overall efficacy rate of the observation group was significantly higher than that of the control group(P<0.05);In the observation group,the levels of PCT,CRP and TNF-αwere significantly lower than those in the control group(P<0.05);the blood gas analysis indexes SaO_(2) and PaO_(2) were higher than those in the control group,and PaCO_(2) was lower than that in the control group(P<0.05);the GCS score in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Nebulized inhalation of budesonide can reduce the inflammatory reaction of patients with severe brain injury combined with pulmonary infection,thereby alleviating clinical symptoms,improving respiratory function and alleviating secondary brain injury.

关 键 词：布地奈德 重型颅脑损伤 肺部感染 炎症因子 血气分析 

分 类 号：R473.6[医药卫生—护理学]