复方异丙托溴铵雾化吸入对开胸术后患者肺部感染的预防及治疗效果研究

Effect of compound ipratropium bromide inhalation on prevention and treatment of postoperative pulmonary infections in thoracotomy patients

  • 摘要: 目的 探究复方异丙托溴铵雾化吸入对开胸术后患者肺部感染的预防效果。方法 选取2011年1月-2016年12月医院进行开胸手术的患者1022例,分为试验组与对照组各511例,均进行常规护理,对照组给予常规的雾化吸入治疗,试验组施行复方异丙托溴铵雾化吸入治疗,检测患者体内PaO2、PaCO2与PO2/FiO2含量以及肺活量、最大通气量,统计患者肺部感染率,比较两组肺部感染患者治疗时间及治疗总有效率。结果 治疗后,试验组患者肺部感染26例,感染率为5.08%,对照组患者肺部感染52例,感染率为10.18%(P<0.05);发生肺部感染的78例患者共检出病原菌103株,以革兰阴性菌为主;治疗后两组PaO2均增加,PaCO2降低,与治疗前比较差异有统计学意义(P<0.05),治疗后对照组患者PO2/FiO2平均水平低于试验组(P<0.05);对照组患者肺水肿和肺不张的发生率高于试验组(P<0.05);对照组平均治疗时间长于试验组(P<0.05);对照组治疗总有效率低于试验组(P<0.05)。结论 复方异丙托溴铵雾化吸入可减少开胸术后患者肺部感染发生率,有助于及时控制肺部感染,具有良好的治疗效果,利于患者术后护理。

     

    Abstract: OBJECTIVE To observe the effect of compound ipratropium bromide inhalation on prevention of postoperative pulmonary infections in patients undergoing thoracotomy.METHODS A total of 1022 patients who received thoracotomy in the hospital from Jan 2011 to Dec 2016 were enrolled in the study and divided into the experimental group and the control group, with 511 cases in each group, both groups were given conventional nursing, the control group was treated with conventional aerosol inhalation, while the experimental group was given compound ipratropium bromide inhalation. The PaO2, PaCO2 and PO2/FiO2 levels as well as vital capacity, maximum voluntary ventilation of the patients were detected, the incidence of pulmonary infections was statistically analyzed, and the time of treatment and total effective rate of treatment were compared between the two groups of patients with pulmonary infections.RESULTS The infection rate was 5.08% (26 cases of pulmonary infection) in the experimental group after the treatment, 10.18% (52 cases of pulmonary infection) in the control group ( P<0.05). Totally 103 strains of pathogens were isolated from the 78 patients with pulmonary infections, among which the gram-negative bacteria were dominant. The PaO2 level of the two groups of patients was higher after the treatment than before the treatment, while the PaCO2 level of the two groups of patients was lower after the treatment than before the treatment, and there were significant differences (P<0.05); the mean level of PO2/FiO2 of the control group was lower than that of the experimental group after the treatment (P<0.05). The incidence rates of pulmonary edema and pulmonary atelectasis were higher in the control group than in the experimental group (P<0.05).The mean treatment time of the control group was longer than that of the experimental group (P<0.05). TheHT5"SS total effective rate of treatment of the control group was lower than that of the experimental group (P<0.05).CONCLUSION The compound ipratropium bromide inhalation may reduce the incidence of postoperative pulmonary infections in the thoracotomy patients, facilitate the timely control of the pulmonary infections, achieve favorable curative effect and benefit postoperative nursing.

     

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