目的 探討痰熱清注射液聯(lián)合異丙托溴銨治療顱腦損傷后肺部感染的臨床療效。方法 選取2014年2月-2015年3月屯昌縣人民醫(yī)院收治的顱腦損傷合并肺部感染患者200例,隨機(jī)分為對照組和治療組,每組100例。對照組在抗菌治療的基礎(chǔ)上使用異丙托溴銨氣霧劑,2撳/次,3次/d。治療組在對照組治療基礎(chǔ)上霧化吸入痰熱清注射液,將痰熱清注射液10mL加入到生理鹽水10 mL中進(jìn)行霧化吸入,2次/d。兩組均連續(xù)治療4周。觀察兩組的臨床療效,同時比較治療前后兩組氧分壓(pO₂)、二氧化碳分壓(pCO₂)、血氧飽和度(SpO₂)、氧合指數(shù)(pO₂/FiO₂)的變化。比較兩組感染控制率、感染控制時間、重癥監(jiān)護(hù)時間和住院時間。結(jié)果 治療后,對照組和治療組總有效率分別為70.0%、90.0%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組pO₂、SaO₂、pO₂/FiO₂顯著升高,pCO₂顯著降低,同組治療前后差異均有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,治療組的感染控制率明顯高于對照組,治療組感染控制時間、重癥監(jiān)護(hù)時間都短于對照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 痰熱清注射液聯(lián)合異丙托溴銨治療顱腦損傷后肺部感染具有較好的臨床療效,能縮短感染控制時間,提高感染控制率,具有一定的臨床推廣應(yīng)用價值。

Objective To observe the clinical effect of Tanreqing Injection combined with ipratropium bromide in treatment of pulmonary infection after craniocerebral injury. Methods Patients (200 cases) with pulmonary infection after craniocerebral injury in the People's Hospital of Tunchang County from February 2014 to March 2015 were randomly divided into control (n=100) and treatment (n=100) groups. The patients in the control group were given Ipratropium Bromide Aerosol on the basis of antimicrobial treatment, 2 presses/time, three times daily. The patients in the treatment group were aerosol inhalation administered with Tanreqing Injection on the basis of the control group, 10 mL added into normal saline 10 mL, twice daily. The patients in two groups were treated for 4 weeks. After treatment, the efficacy was evaluated, and the changes of pO₂, pCO₂, SpO₂, and pO₂/FiO₂ in two groups before and after treatment were compared. The infection control rate, infection control time, intensive care time, and hospital stays time in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 70.0% and 90.0%, respectively, and there were differences between two groups (P < 0.05). After treatment, pO₂, SaO₂, and pO₂/FiO₂ in two groups were significantly increased, pCO₂ was significantly decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, infection control rate in the treatment group was higher than that in the control group, and infection control time, intensive care time in the treatment group were shorter than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Tanreqing Injection combined with ipratropium bromide has clinical curative effect in treatment of pulmonary infection after craniocerebral injury, and can shorten infection control time, also can improve infection control rate, which has a certain clinical application value.