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Natural History, Outcomes and Antibiotic Treatment for Ventilator-Associated Tracheobronchitis in Critical Ill Patients
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作者 Yuxiu Lei Jana Hudcova +7 位作者 Jawad Rashid Akmal Sarwar Wendy Gillespie Carol Finn Marie Goggin Mohamed B. Omran Edward Boroda Donald E. Craven 《Modern Research in Inflammation》 2016年第1期1-11,共11页
We assessed incidence and outcomes of patients with ventilator-associated respiratory infections (VARI) due to tracheobronchitis (VAT) and pneumonia (VAP), including length of intensive care unit (ICU) stay and ventil... We assessed incidence and outcomes of patients with ventilator-associated respiratory infections (VARI) due to tracheobronchitis (VAT) and pneumonia (VAP), including length of intensive care unit (ICU) stay and ventilator days. We also examined pathogens, rate of progression from VAT to VAP, and impact of antibiotic therapy for VAT. Data analysis included 234 patients, 100 patients (43%) had at least moderate (+++) bacterial growth in their semi-quantitative endotracheal aspirate (SQ-ETA) cultures. VAT and VAP were each diagnosed in 34 (15%) patients. Staphylococcus aureus was the most common pathogen isolated and had the highest rate of progression from VAT to VAP. Seven (21%) of the 34 patients were diagnosed with VAT that later progressed to VAP in averaged 3 days. Patients diagnosed with VAT had significantly more ventilator days (9 vs 6, p p < 0.001) and hospital days (22 vs 17, p < 0.001). No significant difference was observed in the clinical outcomes of the 25 VAT patients with timely, appropriate antibiotics compared to the 9 VAT patients who did not receive timely appropriate antibiotics. VAT was a risk factor for increased ventilator days, longer length of ICU and hospital stay. The time window from VAT to VAP allowed physicians to identify the pathogens and sensitivity profile needed to treat VAT with appropriate antibiotics. Data from well-designed studies were needed to assess the impact of early, appropriate antibiotic therapy for VAT, the choice of antibiotics, as well as the duration and route of administration. 展开更多
关键词 ventilator-associated tracheobronchitis (VAT) and Pneumonia (VAP) Bacterial Pathogens Semi-Quantitative Endotracheal Aspirate (SQ-ETA) Cultures Antibiotic Therapy
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Causative bacteria of ventilator-associated pneumonia in intensive care unit in Bahrain:Prevalence and antibiotics susceptibility pattern
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作者 Mohamed Eliwa Hassan Safaa Abdulaziz Al-Khawaja +5 位作者 Nermin Kamal Saeed Sana Abdulaziz Al-Khawaja Mahmood Al-Awainati Sara Salah Yusuf Radhi Mohamed Hameed Alsaffar Mohammed Al-Beltagi 《World Journal of Critical Care Medicine》 2023年第3期165-175,共11页
BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients... BACKGROUND Ventilator-associated pneumonia(VAP)is defined as pneumonia that occurs two calendar days following endotracheal intubation or after that.It is the most common infection encountered among intubated patients.VAP incidence showed wide variability between countries.AIM To define the VAP incidence in the intensive care unit(ICU)in the central gove-rnment hospital in Bahrain and review the risk factors and the predominant bacterial pathogens with their antimicrobial susceptibility pattern.METHODS The research was a prospective cross-sectional observational study over six months from November 2019 to June 2020.It included adult and adolescent patients(>14 years old)admitted to the ICU and required intubation and mechanical ventilation.VAP was diagnosed when it occurred after 48 h after endotracheal intubation using the clinical pulmonary infection score,which considers the clinical,laboratory,microbiological,and radiographic evidence.RESULTS The total number of adult patients admitted to the ICU who required intubation and mechanical ventilation during the study period was 155.Forty-six patients developed VAP during their ICU stay(29.7%).The calculated VAP rate was 22.14 events per 1000 ventilator days during the study period,with a mean age of 52 years±20.Most VAP cases had late-onset VAP with a mean number of ICU days before the development of VAP of 9.96±6.55.Gram-negative contributed to most VAP cases in our unit,with multidrug-resistant Acinetobacter being the most identified pathogen.CONCLUSION The reported VAP rate in our ICU was relatively high compared to the international benchmark,which should trigger a vital action plan for reinforcing the implementation of the VAP prevention bundle. 展开更多
关键词 ventilator-associated pneumonia Intensive care unit Antibiotics susceptibility pattern Kingdom of Bahrain Adults Bacterial resistance ACINETOBACTER
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Risk factors for ventilator-associated pneumonia in trauma patients:A descriptive analysis 被引量:17
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作者 Suresh Kumar Arumugam Insolvisagan Mudali +3 位作者 Gustav Strandvik Ayman El-Menyar Ammar Al-Hassani Hassan Al-Thani1 《World Journal of Emergency Medicine》 SCIE CAS 2018年第3期203-210,共8页
BACKGROUND:We sought to evaluate the risk factors for developing ventilator-associated pneumonia(VAP)and whether the location of intubation posed a risk in trauma patients.METHODS:Data were retrospectively reviewed fo... BACKGROUND:We sought to evaluate the risk factors for developing ventilator-associated pneumonia(VAP)and whether the location of intubation posed a risk in trauma patients.METHODS:Data were retrospectively reviewed for adult trauma patients requiring intubation for>48 hours,admitted between 2010 and 2013.Patients’demographics,clinical presentations and outcomes were compared according to intubation location(prehospital intubation[PHI]vs.trauma room[TRI])and presence vs.absence of VAP.Multivariate regression analysis was performed to identify predictors of VAP.RESULTS:Of 471 intubated patients,332 patients met the inclusion criteria(124 had PHI and208 had TRI)with a mean age of 30.7±14.8 years.PHI group had lower GCS(P=0.001),respiratory rate(P=0.001),and higher frequency of head(P=0.02)and chest injuries(P=0.04).The rate of VAP in PHI group was comparable to the TRI group(P=0.60).Patients who developed VAP were 6 years older,had significantly lower GCS and higher ISS,head AIS,and higher rates of polytrauma.The overall mortality was 7.5%,and was not associated with intubation location or pneumonia rates.In the early-VAP group,gram-positive pathogens were more common,while gram-negative microorganisms were more frequently encountered in the late VAP group.Logistic regression analysis and modeling showed that the impact of the location of intubation in predicting the risk of VAP appeared only when chest injury was included in the models.CONCLUSION:In trauma,the risk of developing VAP is multifactorial.However,the location of intubation and presence of chest injury could play an important role. 展开更多
关键词 ventilator-associated PNEUMONIA TRAUMA Mechanical ventilation INTUBATION location INTENSIVE care unit
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Distribution and antibiotic resistance of pathogens isolated from ventilator-associated pneumonia patients in pediatric intensive care unit 被引量:7
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作者 Xiao-fang Cai Ji-min Sun +1 位作者 Lian-sheng Bao Wen-bin Li 《World Journal of Emergency Medicine》 SCIE CAS 2011年第2期117-121,共5页
BACKGROUND: With mechanical ventilation widely used in intensive care unit, the ventilator associated pneumonia (VAP) has become a common and serious complication in critically ill patients. Compared with adults, t... BACKGROUND: With mechanical ventilation widely used in intensive care unit, the ventilator associated pneumonia (VAP) has become a common and serious complication in critically ill patients. Compared with adults, the incidence of VAP and the mortality are higher in children in pediatric intensive care unit (PICU) because of immune deficiency, severe basic diseases, and increased use of artificial airway or mechanical ventilation. Hence it is of significance to study the epidemiology and changes of antibacterial susceptibility in order to reduce the incidence and mortality of VAP in children.METHODS: From January 2008 to June 2010, 2758 children were treated in PICU of Wuhan Children's Hospital. Among them, 171 received mechanical ventilation over 48 hours in PICU, and 46 developed VAP. The distribution and drug-resistance pattern of the pathogenic bacteria isolated from lower respiratory tract aspirations were analyzed. RESULTS:A total of 119 pathogenic microbial strains were isolated. Gram-negative bacilli (G-) were the most (65.55%), followed by fungi (21.01%) and gram-positive cocci (G~, 13.45%). Among them, the most common pathogens were Acinetobacter baummannii, Escherichia coli, Klebsiella pneumoniae, candida albicans and coagulase-negative staphylococci. Antibiotic susceptibility tests indicated that the multiple drug-resistances of G- and G+to antibiotics were serious. Most of G- was sensitive to ciprofloxacin, amikacin, imipenem, meropenem, cefoperazone-sulbactam and piperacillin-tazobactam. The susceptibility of G+ to vancomycin, teicoplanin and linezolid were 100%. Fungi were almost sensitive to all the antifungal agents. The primary pathogens of VAP were G-, and their multiple drug-resistances were serious. CONCLUSION: In clinical practice we should choose the most sensitive drug for VAP according to pathogenic test. 展开更多
关键词 PEDIATRIC Intensive care unit ventilator-associated pneumonia PATHOGEN DRUG-RESISTANCE Retrospective clinical study
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Effect of traditional Chinese preparation Xuebijing on inflammatory markers in patients with ventilator-associated pneumonia 被引量:2
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作者 Hong-wei Zhang Li-you Wei +6 位作者 Ji-xuan Wang Shu-zheng Liu Dan Xing Rui Zhang Hui Guo Li-juan Chen Jing Zhang 《Journal of Acute Disease》 2021年第5期216-220,共5页
Objective:To observe the effect of Xuebijing,a complex traditional Chinese preparation,on inflammation and prognosis of patients with pneumonia.Methods:The patients with ventilator-associated pneumonia in the intensiv... Objective:To observe the effect of Xuebijing,a complex traditional Chinese preparation,on inflammation and prognosis of patients with pneumonia.Methods:The patients with ventilator-associated pneumonia in the intensive care unit(ICU)were randomly divided into the control group and the treatment group with 35 cases in each group.Both groups were given routine treatment such as anti-inflammatory drugs,rehydration,expectorant,and nutritional support,while the treatment group was additionally given Xuebijing injection.Serum C-reactive protein(CRP),clinical pulmonary infection score(CPIS),acute physiology,and chronic health scoreⅡ(APACHEⅡ)were recorded before treatment,the 3rd and 7th day after treatment.The duration of antibiotic use,mechanical ventilation,ICU stay,and mortality during 28 days was recorded.Results:There was no significant difference in CRP,CPIS,and APACHEⅡbetween the two groups before treatment(P>0.05).The improvement of CRP,CPIS,and APACHEⅡin the treatment group was better than those in the control group on the 3 and 7 days after treatment,and the differences were statistically significant(P<0.05).The duration of antibiotic use,mechanical ventilation,and ICU stay in the treatment group were less than those in the control group(P<0.05).The 28-day mortality of the treatment group was lower than that of the control group,but the difference was not statistically significant(P>0.05).Conclusions:Xuebijing injection can improve the inflammatory indexes of patients with ventilator-associated pneumonia,and can partly improve the prognosis. 展开更多
关键词 Xuebijing injection ventilator-associated pneumonia C-reactive protein Clinical pulmonary infection score APACHEⅡ
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Respiratory mechanics,ventilator-associated pneumonia and outcomes in intensive care unit 被引量:7
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作者 Kelser de Souza Kock Rosemeri Maurici 《World Journal of Critical Care Medicine》 2018年第1期24-30,共7页
AIM To evaluate the predictive capability of respiratory mechanics for the development of ventilator-associated pneumonia (VAP) and mortality in the intensive care unit(ICU) of a hospital in southern Brazil. METHODS A... AIM To evaluate the predictive capability of respiratory mechanics for the development of ventilator-associated pneumonia (VAP) and mortality in the intensive care unit(ICU) of a hospital in southern Brazil. METHODS A cohort study was conducted between, involving a sample of 120 individuals. Static measurements of compliance and resistance of the respiratory system in pressure-controlled ventilation (PCV) and volumecontrolled ventilation(VCV) modes in the 1 st and 5 th days of hospitalization were performed to monitor respiratory mechanics. The severity of the patients' illness was quantified by the Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ). The diagnosis of VAP was made based on clinical, radiological and laboratory parameters.RESULTS The significant associations found for the development of VAP were APACHE Ⅱ scores above the average(P = 0.016), duration of MV (P = 0.001) and ICU length of stay above the average(P = 0.003), male gender(P = 0.004), and worsening of respiratory resistance in PCV mode(P = 0.010). Age above the average(P < 0.001), low level of oxygenation on day 1(P = 0.003) and day 5 (P = 0.004) and low lung compliance during VCV on day 1 (P = 0.032) were associated with death as the outcome.CONCLUSION The worsening of airway resistance in PCV mode indicated the possibility of early diagnosis of VAP. Low lung compliance during VCV and low oxygenation index were death-related prognostic indicators. 展开更多
关键词 Respiratory mechanics Respiratory tract infection ventilator-associated pneumonia
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Ventilator-associated pneumonia in patients with cancer: Impact of multidrug resistant bacteria 被引量:2
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作者 Patricia Cornejo-Juárez Ivan González-Oros +2 位作者 Paola Mota-Castañeda Diana Vilar-Compte Patricia Volkow-Fernández 《World Journal of Critical Care Medicine》 2020年第3期43-53,共11页
BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,c... BACKGROUND Patients with cancer have several risk factors for developing respiratory failure requiring mechanical ventilation(MV).The emergence of multidrug resistant bacteria(MDRB)has become a public health problem,creating a new burden on medical care in hospitals,particularly for patients admitted to the intensive care unit(ICU).AIM To describe risk factors for ventilator-acquired pneumonia(VAP)in patients with cancer and to evaluate the impact of MDRB.METHODS A retrospective study was performed from January 2016 to December 2018 at a cancer referral center in Mexico City,which included all patients who were admitted to the ICU and required MV≥48 h.They were classified as those who developed VAP versus those who did not;pathogens isolated,including MDRB.Clinical evolution at 60-d was assessed.Descriptive analysis was carried out;comparison was performed between VAP vs non-VAP and MDRB vs non-MDRB.RESULTS Two hundred sixty-three patients were included in the study;mean age was 51.9 years;52.1%were male;68.4%had solid tumors.There were 32 episodes of VAP with a rate of 12.2%;11.5 episodes/1000 ventilation-days.The most frequent bacteria isolated were the following:Klebsiella spp.[n=9,four were Extended-Spectrum Beta-Lactamase(ESBL)producers,one was Carbapenem-resistant(CR)];Escherichia coli(n=5,one was ESBL),and Pseudomonas aeruginosa(n=8,two were CR).One Methicillin-susceptible Staphylococcus aureus was identified.In multivariate analysis,the sole risk factor associated for VAP was length of ICU stay(OR=1.1;95%CI:1.03-1.17;P=0.003).Sixty-day mortality was 53%in VAP and 43%without VAP(P=0.342).There was not higher mortality in those patients with MDRB.CONCLUSION This study highlights the high percentage of Gram-negative bacteria,which allows the initiation of empiric antibiotic coverage for these pathogens.In this retrospective,single center,observational study,MDRB VAP was not directly linked to increased mortality at 60 days. 展开更多
关键词 ventilator-associated pneumonia CANCER Multidrug resistance bacteria MORTALITY Intensive care unit Mechanical ventilation
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Antimicrobial resistance pattern in ventilator-associated pneumonia in an intensive care unit of Babol, northern Iran
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作者 Mahmoud Sadeghi-Haddad-Zavareh Hadi Ahmadi Jouybari +6 位作者 Mostafa Javanian Mehran Shokri Masomeh Bayani Mohammad Reza Hasanjani Roushan Arefeh Babazadeh Soheil Ebrahimpour Parviz Amri Maleh 《Journal of Acute Disease》 2018年第2期74-77,共4页
Objective:To investigate antibiotic resistance pattern of ventilator-assiated pneumonia (VAP) generating microorganisms,and quantitative culture and determining antibiotic sensitivity.Methods:This cross sectional stud... Objective:To investigate antibiotic resistance pattern of ventilator-assiated pneumonia (VAP) generating microorganisms,and quantitative culture and determining antibiotic sensitivity.Methods:This cross sectional study was performed on 50 patients suffering from VAP in intensive care unit of Ayatollah Rouhani Hospital,Babol,Iran during 2014-2015.VAP was probable for them based on clinical signs and the criteria of Clinical Pulmonary Infection Score standards.Lower respiratory samples were given under bronchoalveolar lavage and quantitative culture was done on them.Afterwards by microdilution method,minimal inhibitory concentration based on respective microorganisms,considering clinical pulmonary infection score were determined.Results:From 50 investigated samples in this study,the most common microorganisms were Acinetobacter baumannii (A.baumannii) (70%) then Pseudomonas aeruginosa (12%),Staphylococcus aureus (8%) and Klebsiella pneumonia (3%).In our study A.baummannii showed approximate 100% resistance to all antibiotics,in a way that A.baumannii resistance to imipenem and meropenem and piperacillin/tazobactam each was 97.1%.The most resistance of Pseudomonas aeruginosa was 66.7% to each cefepime and ceftazidime and clavulanate/ticarcillin.Staphylococcus aureus showed 75% resistance to nafcillin,cloxacillin and resistance in case of vancomycin was not seen.Conclusion:In current study,A.baumannii had the most prevalence among VAP and this species is resistant to most of antibiotics.Using ceftazidime,cefepime and clavulanate/ticarcillin,in treatment of the patients suffering VAP is not reasonable. 展开更多
关键词 ANTIBACTERIAL resistant ventilator-associated PNEUMONIA INTENSIVE CARE unit
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Ventilator-associated events: From surveillance to optimizing management
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作者 Sergio Ramirez-Estrada Yolanda Peña-Lopez +1 位作者 Tarsila Vieceli Jordi Rello 《Journal of Intensive Medicine》 CSCD 2023年第3期204-211,共8页
Mechanical ventilation(MV)is a life-support therapy that may predispose to morbid and lethal complications,with ventilator-associated pneumonia(VAP)being the most prevalent.In 2013,the Center for Disease Control(CDC)d... Mechanical ventilation(MV)is a life-support therapy that may predispose to morbid and lethal complications,with ventilator-associated pneumonia(VAP)being the most prevalent.In 2013,the Center for Disease Control(CDC)defined criteria for ventilator-associated events(VAE).Ten years later,a growing number of studies assessing or validating its clinical applicability and the potential benefits of its inclusion have been published.Surveillance with VAE criteria is retrospective and the focus is often on a subset of patients with higher thanlower severity.To date,it is estimated that around 30%of ventilated patients in the intensive care unit(ICU)develop VAE.While surveillance enhances the detection of infectious and non-infectious MV-related complicationsthat are severe enough to impact the patient’s outcomes,there are still many gaps in its classification and management.In this review,we provide an update by discussing VAE etiologies,epidemiology,and classification.Preventive strategies on optimizing ventilation,sedative and neuromuscular blockade therapy,and restrictivefluid management are warranted.An ideal VAE bundle is likely to minimize the period of intubation.We believethat it is time to progress from just surveillance to clinical care.Therefore,with this review,we have aimed toprovide a roadmap for future research on the subject. 展开更多
关键词 Intensive care Mechanical ventilation Infection control ventilator-associated pneumonia
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无免疫缺陷侵袭性曲霉气管-支气管炎合并支气管肺炎1例报道 被引量:4
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作者 黄静 沈庆 +3 位作者 文秀芳 陈元澜 尹长春 陈小容 《上海交通大学学报(医学版)》 CAS CSCD 北大核心 2015年第7期1087-1090,共4页
目的探讨侵袭性曲霉气管-支气管炎(IATB)合并支气管肺炎的临床特点,提高对本病的认识。方法报道分析1例无免疫缺陷IATB合并支气管肺炎患者的临床资料,复习文献探讨其临床表现及支气管镜特点。结果患者,女,46岁,因声音嘶哑10 d,加重伴... 目的探讨侵袭性曲霉气管-支气管炎(IATB)合并支气管肺炎的临床特点,提高对本病的认识。方法报道分析1例无免疫缺陷IATB合并支气管肺炎患者的临床资料,复习文献探讨其临床表现及支气管镜特点。结果患者,女,46岁,因声音嘶哑10 d,加重伴呼吸困难6 d入住耳鼻喉科。门诊纤维喉镜检查示双侧声门下见白色假膜样附着,入院后肺CT示右肺中叶不张,右肺中、下叶见不规则片状密度增高影,入院第2日因呼吸困难加重转入呼吸内科,纤维支气管镜检查距声门2-3 cm气道周围可见较多白色附着物,病理检查见大量曲霉菌菌丝,诊断IATB伴肺炎明确,予以伏立康唑抗真菌治疗,1个月后患者症状基本消失,病灶吸收。复习国内外文献报道IATB主要发生于严重免疫缺陷患者,亦可侵犯轻度免疫功能低下及健康宿主。结论提高对轻度及无免疫缺陷者侵袭性曲霉病的认识,并对不明原因剧烈咳嗽及呼吸困难患者应将IATB作为一个可能的诊断,尝试及时诊断程序,尽早行纤维支气管镜检查等明确诊断,对获得的气管-支气管假膜进行组织学检查,支气管肺泡灌洗液(BALF)进行PCR检查更有助于提高阳性率。 展开更多
关键词 侵袭性曲霉气管-支气管炎 支气管镜检查 诊断
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“清肺止咳化痰汤”治疗急性气管—支气管炎及慢性支气管炎急性发作149例临床研究 被引量:38
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作者 张前进 崔海燕 +4 位作者 黎巍威 褚松龄 张杰 吕凤霞 王华 《中国中医基础医学杂志》 CAS CSCD 北大核心 2017年第2期237-239,265,共4页
目的:观察"清肺止咳化痰汤"对急性气管-支气管炎及慢性支气管炎急性发作的疗效。方法:将观察对象随机分为2组,治疗组给予"清肺止咳化痰汤"煎剂每日1剂,每日2次;对照组给予"急支糖浆"每日3次,每次30 ml。... 目的:观察"清肺止咳化痰汤"对急性气管-支气管炎及慢性支气管炎急性发作的疗效。方法:将观察对象随机分为2组,治疗组给予"清肺止咳化痰汤"煎剂每日1剂,每日2次;对照组给予"急支糖浆"每日3次,每次30 ml。急性气管-支气管炎1周为1个疗程,慢性支气管炎急性发作2周为1个疗程,观察两药的综合疗效以及对咳嗽、咳痰的疗效。结果:对急性气管-支气管炎的治疗,"清肺止咳化痰汤"组临床总有效率及对咳嗽的临床有效率均为94.0%,其中对咳痰的临床有效率为95.2%,对照组"急支糖浆"组临床总有效率及对咳嗽的临床有效率均为92.5%,其中对咳痰的临床有效率为90.0%。"清肺止咳化痰汤"组在对咳痰的治疗上明显优于"急支糖浆"组,差异有统计学意义。对慢性支气管炎急性发作的治疗,"清肺止咳化痰汤"组临床总有效率及对咳嗽和咳痰的临床有效率均为93.8%。对照组"急支糖浆"组临床总有效率及对咳痰的临床有效率均为89.5%,其中对咳嗽的临床有效率为92.1%。在综合疗效和咳痰的治疗方面,"清肺止咳化痰汤"组明显好于"急支糖浆"组,有统计学意义。结论:"清肺止咳化痰汤"疗效明确,在急性气管-支气管炎咳痰的治疗及慢性支气管炎急性发作的综合疗效和咳痰治疗上,均明显优于"急支糖浆",差异有统计学意义。 展开更多
关键词 清肺止咳化痰汤 急性气管-支气管炎 慢性支气管炎急性发作 咳嗽 咳痰
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雾化吸入痰热清针剂对呼吸机相关性支气管炎的影响 被引量:5
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作者 张靖轩 周华荣 +1 位作者 刘宗师 杨智 《现代医院》 2013年第6期5-7,共3页
目的针对无基础肺部感染的呼吸机相关性支气管炎(VAT)患者,观察雾化吸入痰热清针剂的治疗效果。方法将无基础肺部感染的VAT患者随机分配到治疗组和对照组,治疗组采用痰热清进行雾化,2 ml/次,每日3次;对照组采用等量生理盐水雾化,每日3... 目的针对无基础肺部感染的呼吸机相关性支气管炎(VAT)患者,观察雾化吸入痰热清针剂的治疗效果。方法将无基础肺部感染的VAT患者随机分配到治疗组和对照组,治疗组采用痰热清进行雾化,2 ml/次,每日3次;对照组采用等量生理盐水雾化,每日3次。治疗期7天,观察期3个月;比较两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。结果治疗组的VAP发生率及死亡率显著低于对照组;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比较差异均无统计学意义(p>0.05)。结论对于发生VAT的无基础肺部感染患者,雾化吸入痰热清针剂能降低VAP发生率及死亡率。 展开更多
关键词 呼吸机相关性支气管炎 痰热清 雾化吸入
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“清肺化痰颗粒”治疗急性气管—支气管炎及慢性支气管炎急性发作129例临床观察 被引量:11
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作者 张前进 吕凤霞 +1 位作者 王华 王丽勤 《浙江中医药大学学报》 CAS 2011年第5期670-672,680,共4页
[目的]观察"清肺化痰颗粒"对急性气管—支气管炎及慢性支气管炎急性发作的疗效。[方法]将199例观察对象随机分为两组,治疗组129例给予"清肺化痰颗粒",3次/d,每次1袋,1周为1个疗程;对照组70例给予"羚羊清肺丸&q... [目的]观察"清肺化痰颗粒"对急性气管—支气管炎及慢性支气管炎急性发作的疗效。[方法]将199例观察对象随机分为两组,治疗组129例给予"清肺化痰颗粒",3次/d,每次1袋,1周为1个疗程;对照组70例给予"羚羊清肺丸",3次/d,每次1丸,2周为1个疗程。观察两药的综合疗效以及对咳嗽、咳痰的疗效。[结果]治疗组与对照组对慢性支气管炎急性发作综合疗效上无统计学差异,但在咳痰的治疗方面,治疗组明显好于对照组。对急性气管—支气管炎的治疗,治疗组在综合疗效和咳痰的治疗上明显优于对照组。[结论]"清肺化痰颗粒"疗效明确.对于两病的综合疗效以及咳嗽、咳痰的疗效均优于"羚羊清肺丸"。 展开更多
关键词 清肺化痰颗粒 急性气管—支气管炎 慢性支气管炎急性发作 咳嗽 咳痰
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气管支气管炎门诊人数与气象条件的关系 被引量:1
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作者 金玫华 何凡 +5 位作者 沈建勇 顾志伟 韩建康 刘小琦 陈卫峰 朱红 《环境与职业医学》 CAS 北大核心 2008年第6期536-539,共4页
[目的]研究气象条件的变化对气管支气管炎发病的影响程度,建立气象因子与门诊病人数趋势的预报模型,以便开展预测预报服务。[方法]收集湖州市中心医院和湖州市第一人民医院2006年10月至2007年12月门诊就诊资料和同期该地区气象资料,采用... [目的]研究气象条件的变化对气管支气管炎发病的影响程度,建立气象因子与门诊病人数趋势的预报模型,以便开展预测预报服务。[方法]收集湖州市中心医院和湖州市第一人民医院2006年10月至2007年12月门诊就诊资料和同期该地区气象资料,采用Pearson相关分析和Spearman相关分析,并用自动交互检测方法(AID)建立预报模型,采用SASEM4.1统计软件进行数据处理。[结果]湖州市气管支气管炎门诊人数存在明显的季节分布差异,夏季和冬季是此类疾病的2个高发季节,而春季和秋季门诊人数较少;其门诊人数与平均气压、平均气温、最高气温、最低气温、水汽压、大气能见度等气象条件存在较好相关性;影响气管支气管炎门诊人数的主要气象因子有平均气压、能见度、日较差和水汽压,当平均气压≥1020.33hPa且能见度<6.2km时,气管支气管炎门诊人数最高。按周门诊人数拟合气管支气管炎预报模型,可将其门诊人数分为四个预测等级,模型拟合确定系数R2为0.539。[结论]平均气压、能见度、日较差和水汽压等气象因子与气管支气管炎门诊人数密切相关,可利用AID建立模型,开展预测预报,提醒市民注意防范。 展开更多
关键词 气管支气管炎 气象条件 关系 预报
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非肺移植宿主侵袭性气管支气管曲霉病的临床特征和预后分析 被引量:3
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作者 苏珊珊 周颖 +4 位作者 欧阳金生 何海栋 林鹏程 吴庆 李玉苹 《温州医科大学学报》 CAS 2016年第2期79-83,87,共6页
目的:探讨非肺移植宿主侵袭性气管支气管曲霉病(ITBA)的临床特征和预后。方法:回顾性分析自2002年3月至2015年6月间收住温州医科大学附属第一医院呼吸与危重症医学科,确诊为ITBA的19例非肺移植宿主的病例资料,排除气道寄生型的曲霉病和... 目的:探讨非肺移植宿主侵袭性气管支气管曲霉病(ITBA)的临床特征和预后。方法:回顾性分析自2002年3月至2015年6月间收住温州医科大学附属第一医院呼吸与危重症医学科,确诊为ITBA的19例非肺移植宿主的病例资料,排除气道寄生型的曲霉病和变应性支气管肺曲霉病(ABPA),记录患者的临床资料、基础疾病、实验室指标、支气管镜表现和影像学资料及预后。结果:慢性呼吸道疾病(CRD)、糖尿病和恶性肿瘤为主要基础疾病,未发现基础疾病6例,占33%。CRD、糖尿病和免疫功能正常宿主ITBA初始均表现为孤立性曲霉性气管支气管炎,随病情进展可侵袭肺实质,发生侵袭性肺曲霉病(IPA);支气管镜多表现为伪膜型,病情进展后表现为溃疡型,病死率为52.6%(10/19),一旦气管插管呼吸机支持,病死率达100%。恶性肿瘤以血液恶性肿瘤、肺癌为主要基础疾病,血液恶性肿瘤的ITBA常继发于IPA,支气管镜表现为局灶性,以伪膜混合溃疡坏死为主,2例患者死于曲霉相关的大出血。无基础疾病宿主发生ITBA预后明显好于有基础疾病患者。结论:非肺移植宿主ITBA以CRD、糖尿病和恶性肿瘤为常见的基础疾病,也见于无基础疾病宿主。初始以孤立性ITBA为主,支气管镜表现以近段气道、伪膜型为主;血液恶性肿瘤ITBA常继发于IPA,病变局灶,表现为伪膜混合溃疡型。有基础疾病宿主预后差。 展开更多
关键词 侵袭性气管支气管曲霉病 伪膜型气管支气管炎 溃疡型气管支气管炎
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呼吸机相关性气管支气管炎对机械通气患者预后的影响 被引量:5
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作者 王建中 李坚 +1 位作者 魏建军 徐君美 《中国急救医学》 CAS CSCD 北大核心 2012年第8期682-685,共4页
目的评价呼吸机相关性气管支气管炎(ventilator—associatedtracheobronchitis,VAT)对机械通气患者预后的影响。方法选择符合VAT诊断标准(即机械通气48h后出现发热、脓性痰、痰细菌培养阳性及影像学无新出现的浸润影或实变影)56例... 目的评价呼吸机相关性气管支气管炎(ventilator—associatedtracheobronchitis,VAT)对机械通气患者预后的影响。方法选择符合VAT诊断标准(即机械通气48h后出现发热、脓性痰、痰细菌培养阳性及影像学无新出现的浸润影或实变影)56例患者作为研究对象,根据是否发展为呼吸机相关性肺炎(VAP)分成VAT+VAP组(n=22)和VAT组(n=34)。分析两组患者机械通气后抗菌药物使用情况、痰细菌培养结果、机械通气时间、住ICU时问、气管切开率及病死率。结果56例VAT患者纳入本研究。VAT+VAP组的抗菌药物不恰当使用率明显高于VAT组(P=0.001),多重耐药菌分离率及2种或以上细菌混合感染率高于VAT组(P=0.001和P=0.007)。此外,VAT+VAP组的机械通气时间和住ICU时间长于VAT组(P均为0.001),气管切开率与病死率亦高于VAT组(P=0.005和P=0.008)。结论机械通气患者发生VAT后,若不能早期诊断并给予及时的靶向抗菌药物治疗易于发展为VAP,VAT和VAP的连续发生可延长患者机械通气及住ICU时间,增加气管切开率与病死率,影响预后。 展开更多
关键词 呼吸机相关性气管支气管炎(VAT) 呼吸机相关性肺炎(VAP) 机械通气 抗菌药物 预后
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连花急支片与抗生素治疗急性气管-支气管炎的随机对照临床研究 被引量:3
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作者 杨立波 王保群 《中国医药导报》 CAS 2015年第19期128-131,共4页
目的:评价口服连花急支片或抗生素治疗急性气管-支气管炎的效果。方法将河北以岭医院和河北师范大学附属医院2014年9~12月收治的120例急性气管-支气管炎患者随机分为试验组和对照组。试验组服用连花急支片,4片/次,3次/d;对照组服用阿... 目的:评价口服连花急支片或抗生素治疗急性气管-支气管炎的效果。方法将河北以岭医院和河北师范大学附属医院2014年9~12月收治的120例急性气管-支气管炎患者随机分为试验组和对照组。试验组服用连花急支片,4片/次,3次/d;对照组服用阿莫西林胶囊,0.5 g/次,3次/d。疗程2周。主要疗效指标为频繁咳嗽天数和疾病痊愈率。结果试验组频繁咳嗽天数(中位数8 d,95%CI:7.16~9.04 d;均数8.4 d,95%CI:7.6~9.7 d)少于对照组(中位数11 d,95%CI:8.93~13.57 d;均数10.7 d,95%CI:9.7~11.6 d),两组比较差异有高度统计学意义(P〈0.01);试验组疾病痊愈率(89.8%)高于对照组(73.3%),两组比较差异有统计学意义(P〈0.05);试验组咳嗽、咯痰、咽干口渴、心胸烦闷和大便干结消失率分别为91.5%、94.9%、93.2%、96.6%和91.5%,对照组分别为73.3%、76.7%、75.0%、71.7%和68.3%,两组比较差异均有高度统计学意义(P〈0.01);试验组不良反应发生率(1.7%)低于对照组(11.7%),差异有统计学意义(P〈0.05)。结论连花急支片治疗单纯急性气管-支气管炎的效果优于阿莫西林胶囊,不良反应发生率低,对于临床医生的日常临床实践具有重要启示。 展开更多
关键词 连花急支片 阿莫西林胶囊 急性气管-支气管炎
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加减小青龙汤治疗小儿反复气管支气管炎非急性感染期虚寒型 被引量:3
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作者 邱蓉 丛丽 《长春中医药大学学报》 2015年第5期1036-1039,共4页
目的观察加减小青龙汤治疗小儿反复气管支气管炎非急性期(虚寒型)的临床疗效。方法将88例患儿随机分为2组,治疗组58例口服加减小青龙汤(桂枝、白芍、细辛、制半夏等)治疗,对照组30例不作特别用药,观察6周,对比2组临床疗效及中医症状改... 目的观察加减小青龙汤治疗小儿反复气管支气管炎非急性期(虚寒型)的临床疗效。方法将88例患儿随机分为2组,治疗组58例口服加减小青龙汤(桂枝、白芍、细辛、制半夏等)治疗,对照组30例不作特别用药,观察6周,对比2组临床疗效及中医症状改善情况。结果治疗组总有效率91.38%,明显优于对照组的33.33%(P<0.01),治疗组畏寒、遇冷咳嗽、流涕等中医症状明显改善,虚寒体质明显改善。结论加减小青龙汤能明显减轻小儿反复气管支气管炎的发病程度,改善中医虚寒体质,并减少复发。 展开更多
关键词 小儿 反复气管支气管炎 非急性感染期 虚寒型 加减小青龙汤
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呼吸机相关性下呼吸道感染的微生物学诊断研究进展 被引量:3
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作者 刘兆润 董丽 《医学综述》 2016年第18期3587-3591,共5页
呼吸机相关性下呼吸道感染(VARI)是指机械通气48 h以后发生的下呼吸道感染,表现为呼吸机相关性气管支气管炎(VAT)和呼吸机相关性肺炎(VAP)。VAT和VAP临床上往往难以区分,VARI则提示感染,并考虑应用抗生素治疗。通过流行病学和发病机制... 呼吸机相关性下呼吸道感染(VARI)是指机械通气48 h以后发生的下呼吸道感染,表现为呼吸机相关性气管支气管炎(VAT)和呼吸机相关性肺炎(VAP)。VAT和VAP临床上往往难以区分,VARI则提示感染,并考虑应用抗生素治疗。通过流行病学和发病机制、临床诊断、微生物学诊断以及治疗策略等的研究,可明确目前关于VAT、VAP、定植的诊断标准,强调具体的临床和微生物线索的重要性以区分感染和定植,并促进早期恰当的抗生素治疗。 展开更多
关键词 呼吸机相关性下呼吸道感染 呼吸机相关性气管支气管炎 呼吸机相关性肺炎 微生物诊断
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急性气管-支气管炎32例肺通气功能探讨 被引量:1
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作者 林国云 李慎果 《天津医药》 CAS 1994年第8期475-476,共2页
测定32例急性气管-支气管炎患者的肺功能,发现用力肺活量(FVC)正常,一秒钟用力呼气容量(FEV_(1·0))下降,最大中期流量(MMF)和25%肺活量最大呼气流量(V25)减低,提示有阻塞性通气障碍存在。常规抗生素治疗,加用支气管扩张剂(美喘清)... 测定32例急性气管-支气管炎患者的肺功能,发现用力肺活量(FVC)正常,一秒钟用力呼气容量(FEV_(1·0))下降,最大中期流量(MMF)和25%肺活量最大呼气流量(V25)减低,提示有阻塞性通气障碍存在。常规抗生素治疗,加用支气管扩张剂(美喘清)4~7天后肺功能恢复正常,胸闷、憋气症状消失。即时测定肺功能可以排除单纯性上呼吸道感染和观测大、小气道受损情况。 展开更多
关键词 支气管炎 肺功能 美喘清 气管炎
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