盐酸氨溴索注射液治疗脑外伤气管切开术后呼吸道感染的疗效观察

目的探讨盐酸氨溴索注射对脑外伤气管切开术后患者呼吸道感染的疗效。方法将2008年4月-2013年12月来上海中医药大学附属曙光医院就诊的76例接受气管切开术的颅脑外伤患者随机分为治疗组（38例）和对照组（38例）。对照组接受支气管肺泡灌洗,治疗组在对照组的基础上于气管切开第1天起iv盐酸氨溴索30 mg＋18 mL生理盐水,3次/d,每次间隔8 h,连续使用1周。对比分析两组患者气管切开后呼吸道的感染及控制情况。结果第5、7天,治疗组肺泡灌洗液中白细胞个数明显少于对照组,两组比较差异有统计学意义（P〈0.05）。第3、5、7天,治疗组肺泡灌洗液中多形核细胞数明显少于对照组,两组比较差异有统计学意义（P〈0.05）。气管切开1个月后,治疗组和对照组呼吸道感染发生率分别为60.5%、92.1%,两组比较差异有统计学意义（P〈0.05）。两组感染控制率分别为82.6%、57.1%,两组比较差异有统计学意义（P〈0.05）。结论盐酸氨溴索注射液联合肺泡灌洗对脑外伤气管切开术后患者呼吸道感染的疗效显著,值得推广。

Clinical observation ofAmbroxol Hydrochloride Injection in treatment of respiratory infection after tracheotomy of traumatic brain injury

Objective To explore the efficacy of Ambroxol Hydrochloride Injection in treatment of respiratory infection after tracheotomy of traumatic brain injury. Methods Patients with traeheostomy （76 cases） after traumatic brain injury who came to Shuguang Hospital Affiliated to Shanghai University of TCM for treatment from April 2008 to December 2013 were randomly divided into treatment （38 cases） and control （38 cases） groups. The patients in the control group were received bronchoalveolar lavage. The patients in the treatment group were iv administered with Ambroxol Hydroehloride Injection 30 mg added into 18 mL saline, three times daily, each time interval of 8 h, and continuous used for l week. And the other treatment was the same as the control group. Respiratory tract infection and control situation of two groups were compared after tracheotomy. Results The leukocyte number in alveolar lavage of treatment group was obviously less than that of control group on days 5 and 7, and there were significant differences between the two groups （P 〈 0.05）. The polymorphonuclear cell number in alveolar lavage of treatment group was obviously less than that of control group on the 3, 5, 7 d, and there were significant differences between the two groups （P 〈 0.05）. One month after tracheostomy, incidence of respiratory infection in treatment and control groups were 60.5% and 92.1%, respectively, and there were significant differences between the two groups （P 〈 0.05）. Infection control rate in treatment and control groups were 82.6% and 57.1%, and there were significant differences between the two groups （P 〈 0.05）. Conclusion Ambroxol Hydrochloride Injection combined with bronchoalveolar lavage has a significant effect on respiratory infection with traumatic brain injury after tracheotomy, which is worth promoting.