异丙托溴铵联合痰热清治疗重型颅脑损伤早期气管切开术后肺部感染临床研究
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摘要
目的观察异丙托溴铵联合痰热清治疗重型颅脑损伤早期气管切开术后肺部感染的临床疗效。方法选取医院2017年3月至2018年3月收治的重型颅脑损伤早期气管切开术后肺部感染患者70例,按治疗方法的不同分为对照组和试验组,各35例。两组患者均予吸入用复方异丙托溴铵溶液、盐酸氨溴索注射液、布地奈德混悬液,试验组患者在加用痰热清注射液;两组患者均持续治疗2周。结果试验组总有效率为94. 29%,显著高于对照组的77. 14%(P <0. 05);与治疗前比较,两组患者治疗后的白细胞介素13、血氧分压、血氧饱和度水平显著升高,白细胞三烯B_4、二氧化碳分压水平显著降低,且试验组改善程度明显优于对照组(P <0. 05);两组不良反应发生率相当(8. 57%比11. 43%,P> 0. 05)。结论异丙托溴铵联合痰热清治疗重型颅脑损伤早期气管切开术后肺部感染,可有效改善炎性因子水平和呼吸功能。
Objective To observe the clinical effect of ipratropium bromide combined with Tanreqing Injection in the treatment of pulmonary infection after tracheostomy in patients with severe traumatic brain injury at the early stage. Methods Totally 70 patients with pulmonary infection after tracheostomy for severe traumatic brain injury at the early stage admitted to our hospital from March 2017 to March 2018 were selected and divided into the control group and the experimental group according to the different treatment methods,35 cases in each group. The patients in the two groups were given Compound Ipratropium Bromide Solution for Inhalation,Ambroxol Hydrochloride Injection and Budesonide Suspension for Inhalation,on this basis,the patients in the experimental group were given Tanreqing Injection. The patients in the two groups were continuously treated for 2 weeks. Results The total effective rate of the experimental group was 94. 29%, which was significantly higher than 77. 14% of the control group( P < 0. 05). Compared with before treatment,the levels of interleukin-13,partial pressure of oxygen and blood oxygen saturation in the two groups were significantly increased after treatment,while the levels of leukotriene B_4 and partial pressure of carbon dioxide in the two groups were significantly decreased after treatment, and the improvement of the experimental group was significantly better than that of the control group( P <0. 05). The incidence rate of adverse reactions in the two groups was similar( 8. 57% vs. 11. 43%, P > 0. 05). Conclusion Ipratropium bromide combined with Tanreqing Injection in the treatment of pulmonary infection after tracheostomy in patients with severe traumatic brain injury at the early stage can effectively improve the levels of inflammatory factors and the respiratory function.
Objective To observe the clinical effect of ipratropium bromide combined with Tanreqing Injection in the treatment of pulmonary infection after tracheostomy in patients with severe traumatic brain injury at the early stage. Methods Totally 70 patients with pulmonary infection after tracheostomy for severe traumatic brain injury at the early stage admitted to our hospital from March 2017 to March 2018 were selected and divided into the control group and the experimental group according to the different treatment methods,35 cases in each group. The patients in the two groups were given Compound Ipratropium Bromide Solution for Inhalation,Ambroxol Hydrochloride Injection and Budesonide Suspension for Inhalation,on this basis,the patients in the experimental group were given Tanreqing Injection. The patients in the two groups were continuously treated for 2 weeks. Results The total effective rate of the experimental group was 94. 29%, which was significantly higher than 77. 14% of the control group( P < 0. 05). Compared with before treatment,the levels of interleukin-13,partial pressure of oxygen and blood oxygen saturation in the two groups were significantly increased after treatment,while the levels of leukotriene B_4 and partial pressure of carbon dioxide in the two groups were significantly decreased after treatment, and the improvement of the experimental group was significantly better than that of the control group( P <0. 05). The incidence rate of adverse reactions in the two groups was similar( 8. 57% vs. 11. 43%, P > 0. 05). Conclusion Ipratropium bromide combined with Tanreqing Injection in the treatment of pulmonary infection after tracheostomy in patients with severe traumatic brain injury at the early stage can effectively improve the levels of inflammatory factors and the respiratory function.
引文
[1]刘朝元.依达拉奉联合亚低温对重型颅脑损伤患者氧化应激水平和神经功能恢复的影响[J].中国药业,2017,26(17):46-48.
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[4]高克锋,姜姗,刘贵廷,等.盐酸氨溴索与异丙托溴铵联用于肺癌并慢性阻塞性肺疾病围术期临床研究[J].中国药业,2017,26(14):71-73.
[5]焦保华,赵宗茂.《第4版美国重型颅脑损伤诊疗指南》解读[J].河北医科大学学报,2018,39(2):125-128.
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[7]符树强,麦兴进,余鹏飞,等.不同气管切开时机对重型颅脑损伤患者肺部感染的疗效研究[J].中华医院感染学杂志,2017,27(19):4439-4442.
[8]尤燕平,谭玉兰.老年重症颅脑损伤患者术后肺部感染的危险因素分析[J].神经损伤与功能重建,2016,11(4):359-361.
[9] BYRNE JP,MASON SA,GOMEZ D,et al. Timing of Pharmacologic Venous Thromboembolism Prophylaxis in Severe Traumatic Brain Injury:a Propensity-Matched Cohort Study[J]. Journal of the American College of Surgeons,2016,223(4):621-631.
[10]王铎,郭强.气管切开时机对严重颅脑创伤患者肺部感染救治效果的影响[J].医学临床研究,2016,33(4):716-719.
[11]刘海生,郭强.复方异丙托溴铵雾化联合氨溴索静注治疗老年颅脑外伤气管切开患者的疗效观察[J].中华老年医学杂志,2016,35(7):740-742.
[12]王颖怡,王良玉,邓秀碧,等.痰热清注射液治疗慢性阻塞性肺疾病急性加重期疗效评价[J].中国药业,2017,26(7):46-48.
[13]董亭方,牛晓露,刘丽,等.抗菌药物与痰热清注射液治疗老年脑卒中患者肺部感染的临床研究[J].中华医院感染学杂志,2016,26(16):3713-3715.
[14]王淑华,高霞,张玲玲,等.痰热清联合抗菌药物治疗老年患者肺部感染的临床疗效分析[J].中华医院感染学杂志,2016,26(4):780-782.
[2]杨欣刚,安海龙,马修尧,等.重型颅脑损伤患者气管切开术后肺部感染特点与危险因素分析[J].中华医院感染学杂志,2016,26(2):323-325.
[3] SU X,LI Z,WANG M,et al. The protective effect of different airway humidification liquids to lung after tracheotomy in traumatic brain injury:The role of pulmonary surfactant protein-A(SP-A)[J].Gene,2016,577(1):89-95.
[4]高克锋,姜姗,刘贵廷,等.盐酸氨溴索与异丙托溴铵联用于肺癌并慢性阻塞性肺疾病围术期临床研究[J].中国药业,2017,26(14):71-73.
[5]焦保华,赵宗茂.《第4版美国重型颅脑损伤诊疗指南》解读[J].河北医科大学学报,2018,39(2):125-128.
[6]党帅,马进显,周国平,等.重症颅脑损伤气管切开患者肺部感染的治疗研究[J].中华医院感染学杂志,2016,26(1):71-73.
[7]符树强,麦兴进,余鹏飞,等.不同气管切开时机对重型颅脑损伤患者肺部感染的疗效研究[J].中华医院感染学杂志,2017,27(19):4439-4442.
[8]尤燕平,谭玉兰.老年重症颅脑损伤患者术后肺部感染的危险因素分析[J].神经损伤与功能重建,2016,11(4):359-361.
[9] BYRNE JP,MASON SA,GOMEZ D,et al. Timing of Pharmacologic Venous Thromboembolism Prophylaxis in Severe Traumatic Brain Injury:a Propensity-Matched Cohort Study[J]. Journal of the American College of Surgeons,2016,223(4):621-631.
[10]王铎,郭强.气管切开时机对严重颅脑创伤患者肺部感染救治效果的影响[J].医学临床研究,2016,33(4):716-719.
[11]刘海生,郭强.复方异丙托溴铵雾化联合氨溴索静注治疗老年颅脑外伤气管切开患者的疗效观察[J].中华老年医学杂志,2016,35(7):740-742.
[12]王颖怡,王良玉,邓秀碧,等.痰热清注射液治疗慢性阻塞性肺疾病急性加重期疗效评价[J].中国药业,2017,26(7):46-48.
[13]董亭方,牛晓露,刘丽,等.抗菌药物与痰热清注射液治疗老年脑卒中患者肺部感染的临床研究[J].中华医院感染学杂志,2016,26(16):3713-3715.
[14]王淑华,高霞,张玲玲,等.痰热清联合抗菌药物治疗老年患者肺部感染的临床疗效分析[J].中华医院感染学杂志,2016,26(4):780-782.
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