摘要
目的探讨头孢哌酮/舒巴坦联合床旁支气管镜灌洗在脑卒中后发生吸入性肺炎的治疗效果。方法选取2019年6月至2020年6月山东省胜利油田中心医院收治脑卒中后继发性吸入性肺炎患者共计98例,根据患者诊疗过程分为头孢哌酮/舒巴坦治疗组(A组,48例)和头孢哌酮舒巴坦联合床旁支气管镜治疗组(B组,50例)。A组在常规治疗的基础上给予头孢哌酮/舒巴坦抗感染;B组在常规治疗及头孢哌酮/舒巴坦抗感染治疗的基础上,给予床旁便携支气管镜检查、灌洗。比较两组治疗前和治疗7 d后患者血气分析指标、白细胞(WBC)计数、降钙素原(PCT)、胸片、致病菌清除率;比较两组治疗7 d后患者体温恢复时间、抗生素应用时间、住院时间及治疗效果。结果治疗7 d后,两组动脉血氧分压(PaO_(2))水平较治疗前升高,动脉血二氧化碳分压(PaCO_(2))、WBC、PCT水平较治疗前下降(P<0.05),B组PaO_(2)水平较A组升高,PaCO_(2)、WBC、PCT水平较A组下降(P<0.05)。B组胸片检查结果优于A组(P<0.05);B组致病菌清除率高于A组(P<0.05)。B组体温恢复时间、抗生素应用时间和住院时间均较A组缩短(P<0.05)。治疗7 d后,B组总有效率高于A组(P<0.05);结论孢哌酮/舒巴坦联合床旁支气管镜灌洗有利于清除气道分泌物、改善临床症状,提高病原菌的分离及清除,在吸入性肺炎中值得推广。
Objective To investigate the effect of Cefoperazone/Sulbactam combined with bedside bronchoscopy lavage in the treatment of aspiration pneumonia after stroke.Methods A total of 98 patients with secondary aspiration pneumonia after stroke admitted to Shengli Oilfield Central Hospital of Shandong Province from June 2019 to June 2020 were selected.According to the diagnosis and treatment process,the patients were divided into Cefoperazone/Sulbactam treatment group(group A,48 cases)and Cefoperazone and Sulbactam combined with bedside bronchoscopy treatment group(group B,50 cases).Group A was given Cefoperazone/Sulbactam to fight infection on the basis of routine treatment.Group B was given bedside portable bronchoscopy and lavage on the basic of routine treatment and Cefoperazone/Sulbactam anti-infection treatment.Blood gas analysis indexes,white blood cell(WBC)count,procalcitonin(PCT),chest film and clearance rate of pathogenic bacteria were compared between the two groups before and after seven days of treatment.The temperature recovery time,antibiotic application time,hospital stay time and treatment effect were compared between the two groups after seven days of treatment.Results After after seven days of treatment,the arterial partial pressure of oxygen(PaO_(2))level in the two groups was increased compared with that before treatment,and the arterial partial pressure of carbon dioxide(PaCO_(2)),WBC,and PCT levels were decreased compared with before treatment(P<0.05).The levels of PaO_(2) in group B were higher than those in group A,while the levels of PaCO_(2),WBC,and PCT were lower than those in group A(P<0.05).The results of chest radiography in group B were better than that in group A(P<0.05).The clearance rate of pathogenic bacteria in group B was higher than that in group A(P<0.05).Body temperature recovery time,antibiotic application time,and hospital stay time in group B were shorter than those in group A(P<0.05).After after seven days of treatment,the total effective rate of group B was higher than that
作者
郝兴亮
纪艳荣
张建
王乃志
李霜
王莹莹
HAO Xingliang;JI Yanrong;ZHANG Jian;WANG Naizhi;LI Shuang;WANG Yingying(Department of Respiratory and Critical Care Medicine,Shengli Oilfield Central Hospital,Shandong Province,Dongying 257034,China;Department of Pharmacy Clinical Pharmacy,Shengli Oilfield Central Hospital,Shandong Province,Dongying 257034,China)
出处
《中国医药导报》
CAS
2022年第8期117-120,125,共5页
China Medical Herald
基金
山东省医药卫生科技发展计划项目(202103020493)。
