短期使用抗生素或雾化吸入痰热清注射液对呼吸机相关性支气管炎患者影响的研究

A Research about the Effect of Aerosol Inhalation of Tanreqing Injection or Short-term Use of Antibiotics for the Patients with Ventilator-associated Tracheobronehitis

目的比较雾化吸入痰热清注射液及短期使用抗生素治疗无基础肺部感染的呼吸机相关性支气管炎(VAT)患者的效果。方法将患者随机分配到口服抗生素治疗组、静脉抗生素治疗组、雾化痰热清组和对照组。分别给予鼻饲抗生素、静脉抗生素及雾化痰热清注射液、等量0.9%氯化钠注射液治疗。治疗期7 d,观察期3个月,比较各组患者呼吸机相关性肺炎(VAP)发生率、有创机械通气时间、入住ICU时长、死亡率等情况。结果各治疗组的VAP发生率及死亡率显著低于对照组,抗生素治疗组和雾化吸入组的VAP发生率和死亡率;治疗组和对照组在ICU住院日、有创呼吸机辅助通气时间等方面相近(P>0.05)。结论对于发生VAT的无基础肺部感染患者,雾化吸入痰热清注射液或短期使用抗生素能降低VAP发生率及死亡率。

Objective： To evaluate and compare the effects of Tanreqing Injection and antibiotic to the patients with ventilator-associated tracheobronehitis（VAT）.Methods： the VAT patients were divided into 4 groups randomly：oral antibiotics group（Group A）,intravenous antibiotic group（Group B）,inhalation of Tanreqing group（Group C） and control group（Group D）,Group A and B were treated with antibiotic,according to the results of bacterial culture,Group C were inhaled the of Tanreqing Injection.3 times one day,the treatment continued for 7 days.The incidence rate,mortality rate,days of mechanical ventilation and average of hospital stay were observed.Results： the incidence of VAP and mortality of treatment group was significantly lower than the control group,though the days of mechanical ventilation and average of hospital stay were no statistically significant（P 0.05）.Conclusion： Nebulized injection Yuxingcaos or short-term use of antibiotics can reduce the incidence rate and mortality of VAP for patients with no other pulmonary disease.