摘要
目的:分析高频胸壁震荡排痰联合纤支镜灌洗治疗重症脑出血术后院内获得性肺炎(HAP)患者的临床疗效。方法:将48例重症脑出血术后并发HAP患者随机分为研究治疗组、常规治疗组,给予常规治疗组患者常规护理及治疗,研究治疗组患者每天先行高频胸壁震荡排痰,再行纤支镜灌洗进行气道清理,每天2次,早晚各1次。确诊为HAP后治疗后第1天、第3天、第7天进行床边X光片或者胸部CT影像学检查,同时检测WBC、PCT、CRP,进行APACHEⅡ评分。结果:研究治疗组患者的疾病治疗总有效率为95.83%,高于常规治疗组的79.16%(P<0.05)。治疗第1天两组患者WBC、PCT、CRP比较无明显差异(P>0.05),治疗后3天、7天研究治疗组患者上述指标均较常规治疗组低(P<0.05)。两组治疗前的APACHEⅡ评分比较无明显差异(P>0.05),研究治疗组治疗后的APACHEⅡ评分较常规治疗组低(P<0.05)。结论:高频胸壁震荡排痰联合纤支镜灌洗治疗重症脑出血术后HAP,疗效可靠,可作为现阶段我国临床常用治疗方案。
Objective： To analyze the clinical efficacy of high-frequency chest wall concussion sputum combined with bronchoscopy lavage in the treatment of nosocomial pneumonia（ HAP） after severe cerebral hemorrhage. Methods： 48 cases of severe cerebral hemorrhage complicated with postoperative HAP patients were randomly divided into treatment group and routine treatment group received routine treatment group and routine nursing care in patients of treatment group with a first HFCWO sputum,and bronchoscopy lavage for airway clearance,2 times a day,morning and evening 1 time. After diagnosis of HAP,bedside X or chest CT imaging examination was performed at 1 D,3 D and 7 d after treatment,and WBC,PCT and CRP were detected at the same time,APACHEⅡ score was performed. Results： the total effective rate of disease treatment in the study group was 95.83%,higher than that of the conventional treatment group 79.16%（ P〈0.05）. There was no significant difference in WBC,PCT and CRP between the two groups of patients treated with 1 D（ P〈0.05）. After treatment,the above indexes in the treatment group were lower than those in the conventional treatment group（ P〈0.05）. There was no significant difference in APACHEⅡ scores between the two groups before treatment（ P〉0.05）,and the APACHEⅡ score in the treatment group was lower than that of the conventional treatment group（ P〈0.05）. Conclusion： high frequency chest wall concussion expectoration combined with bronchoscopy lavage is effective in the treatment of HAP after severe intracerebral hemorrhage. It can be used as a commonly used treatment program in China at this stage.
作者
刘伟清
詹德利
劳永光
Liu Weiqing(Department of Neurology,Zhanjiang People＇s Central Hospital（Zhanjiang,Guangdong 524000)
出处
《黑龙江医药》
CAS
2018年第5期966-969,共4页
Heilongjiang Medicine journal
基金
湛江市非资助科技攻关专题(专题编号:2017B01192)
关键词
经纤支镜肺泡灌洗
振动排痰
重症脑出血
HAP
疗效
sbronchoalveolar lavage through fiberoptic bronchoscopy
vibrating sputum drainage
severe cerebral hemorrhage
HAP
curative effect.
