中药排痰液防治呼吸机相关性肺炎的临床研究
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左明晏

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R181.3+2

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湖北省襄阳市科技局研究开发重点项目(襄科业[2012]42)


Effect of traditional Chinese medicine sputum discharge liquid on preventing and treating ventilatorassociated pneumonia
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    摘要:

    目的探讨中药排痰液在防治呼吸机相关性肺炎(VAP)中的作用。方法采用随机双盲安慰剂对照研究方法,依据纳入和排除标准选取2011—2014年入住某院重症监护病房(ICU)且行机械通气的呼吸衰竭患者,分为治疗组和对照组。治疗组在常规治疗的基础上同时加用排痰液,对照组在常规治疗基础上加用排痰液模拟剂,比较两组患者VAP的发病率、治疗有效率、发生时间及预后情况。结果共监测139例患者,其中治疗组70例,对照组69例。治疗组发生VAP 26例,发病率为37.14%,对照组发生VAP 40例,发病率为57.97%;患者发生VAP的时间:治疗组平均为入ICU后(76±3.2)h,对照组为(45±8.9)h;治疗组VAP患者治疗有效率为88.46%,对照组为55.00%;两组患者VAP的发病率、发生时间、治疗有效率比较,差异均有统计学意义(均P<0.05)。两组患者治疗前后血常规、肝肾功能、尿常规、粪便常规、ECG结果比较,差异均无统计学意义(均P>0.05)。结论应用中药排痰液对机械通气患者进行干预,可降低VAP发病率,对患者疾病及肺部感染的预后均具有积极作用。

    Abstract:

    ObjectiveTo evaluate the effect of traditional Chinese medicine sputum discharge liquid on preventing ventilatorassociated pneumonia(VAP). MethodsA randomized doubleblind, placebocontrolled study  was conducted, according to the inclusion and exclusion criteria, patients with respiratory failure and mechanical ventilation in the intensive care unit (ICU) of a hospital in 2011-2014 were selected and divided into treatment group and control group. Treatment group received sputum discharge liquid in addition to conventional treatment, control group adopted simulation agent based on conventional treatment. The incidence, treatment effectiveness, occurrence time, and prognosis of VAP between two groups of patients were compared. ResultsA total of 139 patients were monitored, 70 cases in treatment group and 69 in control group.  The incidence of VAP in treatment group and control group were  37.14% (n=26) and 57.97%(n=40) respectively; the average onset time of VAP in treatment group and control group were (76±3.2)hours  and (45±8.9)hours after admission to ICU respectively; treatment effectiveness rates in treatment and control group were 88.46% and 55.00% respectively; the incidence, occurrence time,and treatment effectiveness rates of VAP between two groups of patients were both significantly different (all P<0.05). There were no significant difference in blood routine, liver and kidney function, urine routine, stool routine, and  electrocardiogram results between two groups of patients (all P>0.05). ConclusionIntervention in patients with mechanical ventilation by sputum discharge liquid can reduce the incidence of VAP, and has a positive effect on the prognosis of disease and pulmonary infection in patients.

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丁志红,左明晏,卓道勤,等.中药排痰液防治呼吸机相关性肺炎的临床研究[J]. 中国感染控制杂志,2016,15(5):317-320. DOI:10.3969/j. issn.1671-9638.2016.05.007.
DING Zhihong, ZUO Mingyan, ZHUO Daoqin, et al. Effect of traditional Chinese medicine sputum discharge liquid on preventing and treating ventilatorassociated pneumonia[J]. Chin J Infect Control, 2016,15(5):317-320. DOI:10.3969/j. issn.1671-9638.2016.05.007.

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  • 收稿日期:2015-09-30
  • 最后修改日期:2015-12-10
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  • 在线发布日期: 2016-05-30
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