持续气管内滴药与雾化吸入对重度颅脑损伤患者下呼吸道感染影响.docVIP

持续气管内滴药与雾化吸入对重度颅脑损伤患者下呼吸道感染影响 　　[摘要] 目的：比较持续气管内滴药与雾化吸入法对下呼吸道感染的影响。方法：重度颅脑损伤气管切开病人130例，随机分为两组。A组65例，应用持续气管内滴药法湿化气道；B组65例，应用传统雾化吸入法湿化气道，对两组患者进行回顾性对照研究。结果：A组气管切开术后3、7、14 d痰液细菌培养阳性例数均少于B组（P0.05）。痰液细菌培养G－菌占78.28％，G＋菌占21.72％，以铜绿假单胞菌、大肠埃希菌、克雷伯杆菌、金黄色葡萄球菌等多见。结论：应用持续气管内滴药法与应用传统雾化吸入法湿化气道相比，能明显减少重度颅脑损伤气管切开患者下呼吸道感染率和持续时间，促进患者恢复。 　　[关键词] 气管内滴药；雾化吸入；气道湿化；呼吸道感染 　　[中图分类号]R56[文献标识码]A [文章编号]1673-7210（2007）08（c）-018-02 　　 　　The effects of continual endotracheal instillation and atomization inhalation on lower respiratory tract infection in patients of severe head injury 　　LU Ying, ZHANG Peng 　　（Nursing School of Xinxiang Medical College ,Xinxiang 453003,China） 　　[Abstract]Objective: To compare the effectiveness of the continual endotracheal instillation and atomization inhalation on the patients with lower respiratory tract infection. Methods: The patients undergoing tracheotomy with severe head injury were randomly divided into two groups: 65 cases treated with humidifying technique of continual endotracheal instillation were A group; 65 cases dealt with atomization inhalation were B group. Two groups were compared retrospectively. Results: The positive cases of the pathogens in sputum culture at 3th,7th and14th day after tracheotomy in A group were less than those in B group(P0.05). Of the bacteria obtained from sputum culture,the majority were Gram-negative(78.28%),the others were Gram-positive(21.72%).And the major bacteria were aeruginosus bacillus, staphylococcus aureus, escherichia coli, Klebsiella. Conclusion: Continual endotracheal instillation is better than atomization inhalation in humidifying airway, for it can reduce the persistence time of lower respiratory tract infection in the patients with severe head injury, and help patients to recover. 　　[Key words] Endotracheal instillation; Atomization inhalation; Humidifying; Respiratory tract infection 　　 　　气管切开是临床上抢救重度颅脑损伤患者的重要治疗手段，但气管切开后患者的呼吸模式、呼吸途径发生改变，外界气体直接进入气管，未经过鼻腔及咽部的湿化和过滤，将造成呼吸道黏膜干燥，痰液干结不易排出，而且并发下呼吸道感染时，患者