重型颅脑外伤并发肺部感染患者的临床表现及盐酸氨溴索治疗的效果

Clinical manifestations of patients with severe craniocerebral trauma complicated with pulmonary infection and the effect of treatment with ambroxol hydrochloride

目的 探讨重型颅脑外伤并发肺部感染患者的临床表现及应用盐酸氨溴索治疗的效果。方法 选择登封市人民医院2015-01-2018-01收治的ICU重型颅脑外伤并发肺部感染患者50例作为研究对象,纳入对象临床资料完整,愿意配合研究,以随机数表法分为研究组与对照组,每组25例。2组均接受盐酸氨溴索治疗,对照组予以大剂量盐酸氨溴索处理,研究组则采取小剂量盐酸氨溴索处理。回顾性分析2组治疗,记录临床表现、肺部感染病原菌情况,评价2组临床效果,记录不良反应,并对比分析。结果 2组均有不同程度发热、咳嗽咳痰、白细胞增高、肺部干/湿啰音表现,但组间比较差异无统计学意义(P>0.50);2组肺部感染病原菌检查结果显示,以革兰阴性菌为主,其次为革兰阳性菌、真菌,但2组比较差异无统计学意义(P>0.05);研究组总有效率84.00%,对照组76.00%,2组比较差异无统计学意义(P>0.05);2组均有不良反应发生,但研究组发生率显著低于对照组(P<0.05)。结论 ICU重型颅脑外伤并发肺部感染主要有发热、咳嗽咳痰、白细胞增高、肺部干/湿啰音等表现,而且病原菌主要为革兰阴性菌,盐酸氨溴索治疗有不错的效果,但小剂量用药可明显减轻不良反应,安全性更高。

Objective To investigate clinical manifestations of patients with severe craniocerebral trauma complicated with pulmonary infection and the effect of treatment with ambroxol hydrochloride. Methods Selecting 50 patients admitted to our hospital from Jan.2015 to Jan.2018 with ICU severe craniocerebral trauma complicated with pulmonary infection as subjects.The clinical data of the included subjects were complete and they were willing to cooperate with the study.Divided into study group and control group, n =25 cases in each group.Both groups are treated with ambroxol hydrochloride,however,the control group was treated with large doses of ambroxol hydrochloride,and the study group was treated with small doses of ambroxol hydrochloride.The two groups of treatments were retrospectively analyzed.The clinical manifestations and pathogens of pulmonary infection were recorded.The clinical effects of the two groups were evaluated,adverse reactions were recorded,and comparative analysis was performed. Results There were different degrees of fever,cough and increased white blood cells,and dry/wet sputum in two groups,but there was no significant difference between the two groups ( P >0.50);The pathogen test results showed that Gram negative bacteria were the main,followed by Gram positive bacteria and fungi,but the difference between the two groups was not statistically significant ( P >0.05).The total effective rate of the study group was as high as 84.00%,and that of the control group was 76.00%.There was no significant difference between the two groups ( P >0.05).Adverse reactions occurred in both groups,but the incidence of the study group was significantly lower than that of the control group ( P <0.05). Conclusion ICU severe craniocerebral trauma complicated with pulmonary infection mainly includes fever,cough and white blood cell increasing,dry/wet lung sound,and the pathogen is mainly Gram negative bacteria.Treatment with ambroxol hydrochloride has good results,but small doses of medication can significantly reduce adverse reactions,higher safety,it is worth learning.