摘要
目的探讨氨溴索联合振动排痰机在呼吸机相关性肺炎(VAP)患者中的应用效果,为提高临床诊治水平提供参考。方法 2010年6月-2014年10月240例机械通气VAP患者随机分为A、B、C组,每组各80例,所有患者均进行有创呼吸机辅助机械通气,并每天进行脱机试验判断;A组患者仅实施基础治疗,B组患者在基础治疗的基础上采用氨溴索静脉滴注,C组在B组的基础治疗上加用排痰机振动排痰;每天观察并记录患者的体温、心率、呼吸频率等,定期进行血常规、动脉血气和胸片检查,统计急性生理学和慢性健康状况评分Ⅱ(APACHEⅡ),对比3组患者的疗效;采用SPSS 17.0软件进行统计分析。结果治疗前3组患者两两之间的APACHEⅡ评分、氧合指数、心率、呼吸频率的差异均无统计学意义;治疗后各组患者的APACHEⅡ评分、氧合指数、心率、呼吸频率均得以显著改善,差异均有统计学意义(P<0.05),B组和C组患者显著优于A组(P<0.05),C组患者显著优于B组(P<0.05);C组患者的治疗有效率为96.3%,显著高于B组的82.5%和A组的72.5%,差异有统计学意义(P<0.05);无严重并发症和死亡病例发生。结论氨溴索联合振动排痰机在VAP患者中治疗效果优于单纯氨溴索治疗。
OBJECTIVE To explore the effect of ambroxol combined with vibration sputum elimination machine on patients with ventilator‐associated pneumonia （VAP ） so as to improve the clinical diagnosis and treatment . METHODS A total of 240 patients who underwent the mechanical ventilation from Jun 2010 to Oct 2014 were ran‐domly divided into the group A ,B ,and C ;all the patients received the invasive ventilator assisted mechanical ven‐tilation ,and the offline test was conduced everyday for judgment .The group A was only given the basic treatment , the group B was treated with intravenous drip of ambroxol on the basis of the basic treatment ,and the group C was treated with additional vibration sputum elimination machine on the basis of the group B .The body tempera‐ture ,heart rate ,and respiratory frequency were observed and recorded everyday ,regular examinations of blood routines ,arterial blood gas ,and chest radiograph were carried out ,the acute physiology and chronic health evalu‐ation II （APACHE II） score was calculated ,the effects were compared among the three groups ,and the statistical analysis was performed with the use of SPSS 17 .0 software .RESULTS Before the treatment ,there was no signifi‐cant difference in the APACHE Ⅱ score ,oxygenation index ,heart rate ,or respiratory frequency between each two groups of the three groups .The APACHE Ⅱ score ,oxygenation index ,heart rate ,and respiratory frequency were significantly improved after the treatment（P〈0 .05）;the improvement degrees of the group B and C were significantly higher than those of the group A （P〈0 .05） ,and the improvement degrees of the group C were sig‐nificantly higher than those of the group B （P〈0 .05） .The effective rate of treatment of the group C was 96 .3% , significantly higher than 82 .5% of the group B and 72 .5% of the group A .No case had severe complications or died .CONCLUSION Ambroxol combined with vibration sputum elimination machine can achieve more significant effect on treatment of the VAP patients than the single ambroxol therapy .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第10期2259-2261,共3页
Chinese Journal of Nosocomiology
基金
国家青年自然科学基金资助项目(81300052)
关键词
氨溴索
振动排痰机
呼吸机相关性肺炎
Ambroxol
Vibration sputum elimination machine
Ventilator-associated pneumonia
