大剂量氨溴索联合纤支镜肺泡灌洗对颅脑损伤开颅手术合并肺部感染患者效果分析

Analysis of Effect of Large-dose Ambroxol Combined with Bronchoalveolar Lavage in Patients with Craniotomy for Craniocerebral Injury and Lung Infection

目的分析颅脑损伤开颅手术合并肺部感染患者应用大剂量氨溴索联合纤支镜肺泡灌洗的疗效。方法将2015年4月—2016年12月颅脑损伤开颅手术后合并肺部感染的患者76例,随机分为观察组及对照组,两组均为38例,常规抗感染支持治疗基础上均采用纤支镜肺泡灌洗术,对照组灌洗液选择无菌生理盐水,观察组采用大剂量氨溴索,对比两组临床疗效。结果观察组治疗总体有效率为92.10%高于对照组的86.84%,差异无统计学意义(χ~2=2.695,P>0.05),观察组肺泡灌洗后Pa CO2、Pa O2、Sa O2、p H值等血气分析指标比对照组改善更明显,差异有统计学意义(t=7.163、3.310、5.972、8.717,P<0.05)。结论大剂量氨溴索联合纤支镜肺泡灌洗应用于颅脑损伤开颅手术合并肺部感染患者的治疗中,能有效改善血气分析指标,加快临床症状缓解,提高患者的生存质量,值得推广应用。

Objective To analyze the curative effect of large-dose ambroxol combined with bronchoalveolar lavage in patients with craniotomy for craniocerebral injury and lung infection.Methods 76 cases of patients with craniotomy for craniocerebral injury and lung infection in our hospital from April 2015 to December 2016 were selected and randomly divided into two groups with 38 cases in each,both groups used the bronchoalveolar lavage via fiberoptic bronchoscopy on the basis of the routine anti-infection supported treatment,the control group selected the sterile physiological saline,while the observation group used the large-dose ambroxol,and the clinical curative effect was compared between the two groups.Results The total effective rate in the observation group was higher than that in the control group（92.10%vs 86.84%）,and the difference was not statistically significant（χ2=2.895,P〉0.05）,after the alveolar wash,the Pa CO2,PaO2,SaO2,pH value were more obviously improved than the control group,and the differences were statistically significant（t=7.163 、3.310 、5.972 、8.717,P〈0.05）.Conclusion The large-dose ambroxol combined with bronchoalveolar lavage in patients with craniotomy for craniocerebral injury and lung infection can effectively improve the blood gas analysis indicators,accelerate the relief of clinical symptoms and improve the survival quality of patients,and it is worth promotion and application.