医学资料-高压氧治疗对重型颅脑损伤气管切开术后患者肺部感染的影响.pdfVIP

高压氧治疗对重型颅脑损伤气管切开术后 患者肺部感染的影响 许立民 孔磊 肖泉 王栋 刘若平 俸道荣 宋献丽 黄剑平 [摘要] 目的 探讨重型颅脑损伤气管切开术后肺部感染的高压氧(HBO)和常压下吸氧管供氧治疗 的近期治疗效果。方法 选取符合入选标准的重型颅脑损伤气管切开术后肺部感染患者60例,按随机分层 设计分为高压氧组和常规组,每组30例,两组患者均给予吸氧、降颅压、护脑、手术、抗生素及对症支持治疗。 常规组在常压下经气管套管采用一次性吸氧管给氧治疗,高压氧组采用我科自创吸氧连接装置进行高压氧 治疗。观察两组患者体温、咳嗽咳痰、肺部呼吸音、白细胞总数及分类等恢复正常的时间,并进行比较。结 果 高压氧组体温正常、咳嗽咳痰好转、肺部呼吸音清晰、白细胞总数及分类正常的时间明显短于常规组,组 间比较差异有统计学意义(P＜0.01)。结论 高压氧对重型颅脑损伤气管切开肺部感染患者有排痰、化痰作 用,利于肺部感染的控制。 高压氧；颅脑损伤；气管切开术；肺水肿,神经源性；肺部感染 XULi-minKONG Hyperbaricoxygenforlunginfectionpatientswithseverebraininjuryandtracheotomy LeiXIAOQuan WANGDongLIURuo-pingFENGDao-rongSONGXian-li,HUANGJian-ping Departmentof HyperbaricOxygen,ThePeoplesHospitalofGuangxi,Nanning530021,China Objective Tocomparetheeffectivenessofhyperbaricoxygen (HBO)therapyandnormalpres sureoxygeninhalationforlunginfectioninpatientswithseverebraininjuryandtracheotomy. Methods Sixtylung infectionpatientswithseverebraininjuryandtracheotomywerestratifiedbyageandGlasgowcomascale(GCS) scoreintoanHBOgroup(30)andaconventionaltherapygroup(30).Bothgroupsweregiventreatmentstoreduce intracranialhypertensionandprotectthebrain,surgery,antibiotics,andsymptomaticandsupporttherapy.Inthe conventionalgroupthepatientsreceivedoxygentherapyatnormaloxygenpressurebytrachealcannula.IntheHBO group,thepatientsreceivedHBOtherapythroughself-madeoxygendevicesbytheauthors.Thebodytemperature, coughandexpectoration,respiratorysoundsandwhitebloodcell(WBC)countwerecomparedbetweenthegroups. Results Therewerestatisticallysignificantdifferencesinbodytemperature,coughandexpectoration,respiratory soundsandthenormalizedtimeforthecountandclassificationofWBCbetweenthegroups. Conclusion HBOhad goodtreatmenteffectivenessforexcretionandexpectorantinlunginfectionpatientswithseverebraininjuryandtrach eotomy. Hyperbaricoxygenation; Craniocerebraltrauma;Tracheotomy;Pulmonaryedema; Lung infection 10.3760/