排痰液防治呼吸机相关性肺炎的实验及临床研究

Experimental and Clinical Study on Prevention of Ventilator Associated Pneumonia Sputum Discharge

目的通过呼吸机相关性肺炎(VAP)实验动物模型探讨中药复方排痰液止咳祛痰的作用机理并观察排痰液干预行机械通气患者VAP的发病率,探讨排痰液干预的作用机理,评价排痰液干预的疗效。方法实验研究通过小鼠浓氨水引咳实验检测排痰液对反射性咳嗽的止咳作用及酚红排泌试验检测排痰液的排痰作用。临床试验采用随机对照法,选取ICU行机械通气的94例患者,分为对照组和治疗组,对照组采用常规基础治疗(抗感染、对症、支持等),治疗组采用常规基础治疗加排痰液雾化治疗,观察并比较两组VAP发生率和机械通气时间。结果实验研究结果显示,排痰液可显著缩短小鼠引咳潜伏期(P<0.01)和减少咳嗽次数(P<0.01),对气管酚红排泌量增加有统计学意义(P<0.05)。临床结果表明,与对照组比较,排痰液可降低VAP发生率(P<0.05),减少机械通气时间(P<0.05)。结论排痰液对VAP有较好的预防和治疗作用。

Objective To observe the effect of sputum discharge liquid in treating ventilator associated pneumonia in animal model and to observe the intervention of VAP discharge sputum in patients with pulmonary infection incidence rate,so as to provide a clinical reference for the treatment of VAP in ICU patients. Methods 78 cases of ICU mechanical ventilation were selected and divided into control group and treatment group,the control group received conventional treatment（ anti infection,symptomatic support,etc.）,the treatment group received conventional therapy with row sputum atomization,the incidence of VAP and mechanical ventilation time in two groups were observed and compared. Results The result showed that,the discharge sputum group could significantly shorten cough incubation period（ P〈0. 01） and reduced the frequency of cough（ P〈0. 01）,there was statistical significance to increase the tracheal phenol red secretion（ P〈0. 05）. The clinical results showed that,compared with the control group,the sputum drainage could reduce the incidence of VAP and the time of mechanical ventilation（ P〈0. 05）. Conclusion The sputum discharge liquid has better prevention and treatment of VAP.