围术期加用普米克令舒雾化吸入在预防高血压脑出血术后肺部感染中的应用效果

Application effects of combined with Pulmicort aerosol inhalation in prevention pulmonary infection after hypertensive cerebral hemorrhage operation at perioperative period

目的观察在高血压脑出血围术期加用普米克令舒雾化吸入对预防肺部感染的效果,进一步探讨普米克令舒预防肺部感染的临床疗效。方法选择2013年1月~2016年6月我院的128例需进行开颅清除血肿治疗的高血压脑出血患者作为研究对象,分为治疗组(68例)和对照组(60例)。从入院开始直至术后10 d,治疗组使用普米克令舒2 mg+盐酸氨溴索30 mg雾化吸入,3次/d。对照组使用盐酸氨溴索30 mg雾化吸入,3次/d。比较两组术后第1、5、10天的二氧化碳分压(PaCO_2)、氧分压(PaO_2)、氧合指数(OI)及肺部感染出现情况。结果治疗组的PaCO_2、PaO_2、OI水平在术后第5天和第10天均较对照组改善,差异有统计学意义(P<0.05)。治疗组术后的肺部感染发生率为38%,明显低于对照组的58%,差异有统计学意义(P<0.05)。结论高血压脑出血围术期使用普米克令舒联合盐酸氨溴索雾化吸入,能通过提高PaO_2,降低PaCO_2,改善器官组织的氧合情况,有效预防肺部感染的发生。

Objective To observe the effects of combined with Pulmicort aerosol inhalation in prevention pulmonary infection at perioperative period of hypertensive cerebral hemorrhage,and to further explore the clinical effects of Pulmicort in prevention pulmonary infection.Methods 128 hypertensive cerebral hemorrhage patients who needed to craniotomy for removal of hematoma from January 2013 to June 2016 were selected and divided into the treatment group and the control group.68 patients in the treatment group were used Pulmicort 2 mg combined with Ambroxol Hydrochloride30 mg aerosol inhalation for 3 times a day from hospitalized to 10 days after operation,60 patients in the control group were used Ambroxol Hydrochloride 30 mg aerosol inhalation for 3 times a day.The level of PaCO2,PaO2,OI and pulmonary infection situation at 1st,5thand 10 thdays postoperative in the two groups were compared.Results The level of PaCO2,PaO2 and OI in the treatment group at 5thand 10 thdays after operation were improved than those in the control group,and the difference was statistical significance（P0.05）.The incidence rate of postoperative pulmonary infection in the treatment group was 38%,which was lower than that in control group（58%）,with significant difference（P 0.05）.Conclusion Pulmicort combined with Ambroxol Hydrochloride aerosol inhalation at perioperative period of hypertensive cerebral hemorrhage can prevent pulmonary infection effectively by enhancing PaO2 and decreasing PaCO2,improving oxygenation of organs and tissues.