纤维支气管镜下沐舒坦肺泡灌洗对重症脑卒中患者肺部感染的疗效
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李志庆

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R563.1

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湖南省郴州市科技局社会发展计划项目(2010 gl 31)


Effect of mucosolvan bronchoalveolar lavage on stroke patients with pulmonary infection
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    摘要:

    目的观察纤维支气管镜(纤支镜)下沐舒坦肺泡灌洗对重症脑卒中患者肺部感染的治疗效果。方法 选择重症脑卒中合并肺部感染可行纤支镜肺泡灌洗的患者42例,随机分为生理盐水组与沐舒坦组各21例。全部患者入重症监护室(ICU)后进行经验性抗感染、扩张支气管、雾化吸入及静脉滴注沐舒坦等治疗。记录患者开始治疗前APACHEⅡ评分、GCS评分、C反应蛋白(CRP)、 临床肺部感染评分(CPIS),比较2组肺泡灌洗次数、每次肺泡灌洗时间、吸出痰液量、住ICU天数、使用呼吸机时间及灌洗前后CPIS分值。结果2组患者年龄、性别、开始肺泡灌洗前的GCS评分、APACHEⅡ评分、CRP值比较,差异无统计学意义(P>0.05)。沐舒坦组与生理盐水组肺泡灌洗次数、平均每次灌洗时间和灌洗痰液量比较,差异无统计学意义(P=0.05);沐舒坦组使用呼吸机时间(63.57±21.94) h及住ICU时间(6.24±1.04) d少于生理盐水组[分别为(88.24±21.35)h和(7.95±1.36)d],差异有统计学意义(分别t=-3.69,P=0.00;t=-4.58,P=0.00)。灌洗后第3、4天,沐舒坦组CPIS分值(分别为2.36±0.77、2.17±0.81)较生理盐水组(分别为4.16±0.86、3.54±1.09)低,且差异有统计学意义(分别t=3.60,P=0.00;t=2.25,P=0.03)。结论纤支镜下沐舒坦肺泡灌洗能促进脑卒中患者肺部感染的康复。

    Abstract:

    ObjectiveTo evaluate the effect of mucosolvan bronchoalveolar lavage  on stroke patients with pulmonary infection.MethodsFortytwo stroke patients with pulmonary infection were randomly divided into two groups, normal saline group and mucosolvan group were 21 cases respectively. All  patients were treated with antiinfection, bronchodilatation, aerosol inhalation and intravenous drip of mucosolvan in ICU. Observed indicators included acute physiological and chronic health evaluation (APACHE Ⅱ ) score, Glasgow coma scale (GCS) ,Creaction protein (CPR), and clinic pulmonary infection score (CPIS) in all cases. The number of alveolar lavage ,the average duration of lavage,  aspirated sputum volume, the days in ICU , duration of using ventilators and CPIS were compared before and after lavage between two groups.ResultsThere were no significant difference in age, gender, GCS score, APPACHE Ⅱ score and CRP before lavation in both groups(P>0.05), and there was also no  statistical difference in lavage number, average duration of lavage, and aspirated sputum volume between two groups (P=0.05); mucosolvan group had less time on the ventilator ( [63.57±21.94]h )and less  day to stay in ICU([6.24±1.04]d) than saline group([88.24±21.35]h, [7.95±1.36]d ,respectively)(t=-3.69,P=0.00;t=-4.58,P=0.00) ; at the 3rd  and 4th day after lavage ,  CPIS in mucosolvan group was (2.36±0.77) and ( 2.17±0.81) respectively, which were significantly lower than saline group([4.16±0.86],[3.54±1.09], respectively)(t=3.60,P=0.00;t=2.25,P=0.03).ConclusionMucosolvan bronchoalveolar lavage can promote stroke patients to  recover from pulmonary  infection.   

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李志庆,曹国灿,张磊,等.纤维支气管镜下沐舒坦肺泡灌洗对重症脑卒中患者肺部感染的疗效[J]. 中国感染控制杂志,2011,10(3):175-177.
LI Zhiqing, CAO Guocan, ZHANG Lei, et al. Effect of mucosolvan bronchoalveolar lavage on stroke patients with pulmonary infection[J]. Chin J Infect Control, 2011,10(3):175-177.

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  • 收稿日期:2011-02-24
  • 最后修改日期:2011-03-30
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  • 在线发布日期: 2011-05-30
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