摘要
目的研究不同排痰方案对重型颅脑损伤患者呼吸机相关肺炎预防效果,为临床治疗提供参考。方法选择2014年1月-2015年5月在医院就诊的重型颅脑损伤患者200例,按照随机数表法将患者分为研究组和对照组,每组各100例;对照组患者采用传统的叩背排痰法,研究组患者由专门受过培训的干预人员用振动排痰机进行干预,统计患者肺部感染率,对比两组患者的住院时间和机械通气时间及患者的痰液菌株培养结果;采用SPSS19.0软件进行统计分析。结果研究组患者的住院时间和机械通气时间明显少于对照组,差异有统计学意义(P<0.05),研究组患者中有18例发生肺部感染,感染率为18.0%,对照组患者中有38例患者发生肺部感染,感染率为38.0%,研究组患者的肺部感染率明显低于对照组患者,差异有统计学意义(P<0.05);研究组患者培养出18株病原菌,其中革兰阴性菌9株、革兰阳性菌7株和真菌2株,对照组患者培养出38株病原菌,其中革兰阴性菌16株、革兰阳性菌14株和真菌8株,研究组患者的细菌株数明显少于对照组,差异有统计学意义(P<0.05)。结论振动排痰能够明显降低患者呼吸机相关肺炎,减少患者住院时间和机械通气时间,减少人力资源,具有较高的临床实用价值。
OBJECTIVE To observe the effects of different expectoration plans on prevention of ventilator-associated pneumonia in patients with severe craniocerebral injury so as to provide guidance for clinical treatment.METHODS A total of 200 patients with severe craniocerebral injury who were treated in the hospital from Jan 2014 to May2015were enrolled in the study and randomly divided into the study group and the control group,with 100 cases in each.The control group was treated with the traditional percussion on back expectoration method,and the study group was treated with vibration expectoration machine by specially trained staff.The incidence of pulmonary infections was taken for statistics,the length of hospital stay,mechanical ventilation duration,and results of sputum culture were observed and compared between the two groups of patients;the statistical analysis was performed with the use of SPSS19.0software.RESULTS The length of hospital stay and mechanical ventilation duration of the study group were significantly shorter than those of the control group（P〈0.05）.The pulmonary infections occurred in 18 cases in the study group,with the infection rate 18.0%;the pulmonary infections occurred in38 cases in the control group,with the infection rate of 38.0%;the infection rate of the study group was significantly lower than that of the control group（P〈0.05）.Totally 18 strains of pathogens were isolated from the patients in the study group,including 9strains of gram-negative bacteria,7strains of gram-positive bacteria,and 2strains of fungi;totally 38 strains of pathogens were isolated from the patients in the control group,including 16 strains of gram-negative bacteria,14 strains of gram-positive bacteria,and 8strains of fungi;the number of the strains was significantly less in the study group than in the control group（P〈0.05）.CONCLUSIONThe vibration expectoration can effectively reduce the incidence of ventilator-associated pneumonia,shorten the length of hospital stay and mechanical ventilation duration,and reduce the human resources;it is worthy to be promoted in hospitals.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第2期326-328,共3页
Chinese Journal of Nosocomiology
基金
山东省自然科学基金资助项目(ZR2009CL018)
关键词
排痰方案
重型颅脑损伤
肺部感染
预防效果
Expectoration plan
Severe craniocerebral injury
Pulmonary infection
Preventive effect
