CAJ | 학술논문

目的观察沐舒坦静脉注射联合纤支镜下肺灌洗对重型颅脑损伤气管切开术后患者肺部感染的疗效.方法将广州市花都区人民医院神经外科自2009年1月25日至2010年11月25日收治的42例重型颅脑损伤气管切开术后患者按随机数字表法分为联合治疗组(沐舒坦静脉注射+纤支镜下肺灌洗)和对照组(纤支镜下肺灌洗),每组各21例.气管切开术后第1、3、5、7天取患者支气管肺灌洗液做细胞学检查,并观察气管切开术后1月内患者肺部感染及控制情况、气管套管拔除例数.结果联合治疗组患者支气管肺灌洗液中白细胞数在气管切开术后第5、7天明显降低,多形核细胞数在第3、5、7天明显降低,与对照组比较差异均有统计学意义(P＜0.05).联合治疗组患者气管切开术后1月内肺部感染例数(12例)、感染控制时间[(7.08±2.10)d]以及拔除气管套管例数(13例)与对照组[19例,(11.86±3.63)d,5例]比较差异均有统计学意义(P＜0.05).结论沐舒坦静脉注射联合纤支镜下肺灌洗可减轻重型颅脑损伤气管切开术后患者早期气道炎症反应,对肺部感染防治及气道恢复较单纯肺灌洗疗效更明显.
목적 관찰목서탄정맥주사연합섬지경하폐관세대중형로뇌손상기관절개술후환자폐부감염적료효.방법 장엄주시화도구인민의원신경외과자2009년1월25일지2010년11월25일수치적42례중형로뇌손상기관절개술후환자안수궤수자표법분위연합치료조(목서탄정맥주사+섬지경하폐관세)화대조조(섬지경하폐관세),매조각21례.기관절개술후제1、3、5、7천취환자지기관폐관세액주세포학검사,병관찰기관절개술후1월내환자폐부감염급공제정황、기관투관발제례수.결과 연합치료조환자지기관폐관세액중백세포수재기관절개술후제5、7천명현강저,다형핵세포수재제3、5、7천명현강저,여대조조비교차이균유통계학의의(P＜0.05).연합치료조환자기관절개술후1월내폐부감염례수(12례)、감염공제시간[(7.08±2.10)d]이급발제기관투관례수(13례)여대조조[19례,(11.86±3.63)d,5례]비교차이균유통계학의의(P＜0.05).결론 목서탄정맥주사연합섬지경하폐관세가감경중형로뇌손상기관절개술후환자조기기도염증반응,대폐부감염방치급기도회복교단순폐관세료효경명현.
Objective To observe the effects of mucosolvan combined with bronchoalveolar lavage on pulmonary infection of tracheostomy patients after severe traumatic brain injury.Methods Forty-two patients were chosen in our study and divided randomly into combination therapy group (mucosolvan injection combined with bronchoalveolar lavage,n=21)and control group(bronchoalveolar lavage alone,n=21).Their bronchoalveolar lavage fluid was examined cytologically.One month after tracheostomy,the pulmonary infection conditions of these patients and their control status were observed,and the number of patients performed removal of trachea cannula was calculated.Results Leucocyte count in the bronchoalveolar lavage fluid in combination therapy group was significantly reduced since the 5th and 7th d oftratment,and their polymorphocyte count was significantly reduced on the 3rd,5th and 7th d of treatment as compared with those in the control group(P＜0.05); significant differences were also noted between the 2 groups in the number of patients with pneumonia 1 month after tracheostomy,the days that patients′ infections were controlled and the numbers of patients whose trachea cannula were removed(P＜0.05).Conclusion Mucosolvan combined with bronchoalveolar lavage can reduce the early inflammation of the airway,and has more obvious therapeutic effect on pulmonary infection and recovery of airway than bronchoalveolar lavage alone.