持续气管内滴药预防气管切开术后肺部感染的疗效观察

目的 观察持续气管内滴药预防气管切开术后肺部感染的临床效果,比较其与多种方法治疗结果的差异.方法 回顾性分析92例气管切开患者的病例资料,其中36例给予持续气管内滴药治疗（A组）,29例给予雾化吸入治疗（B组）,27例行间歇气管内滴药治疗（C组）,分析不同方法治疗后不同时间点三组患者痰液细菌培养阳性率及血液内氧氟沙星浓度的差异,分析持续气管内滴药预防肺部感染的临床效果.结果 三组气管切开后3、6、9、12 d痰液细菌培养阳性率比较,差异有统计学意义（P=0.031、0.025、0.016、0.021）,A组显著低于其他两组;三组治疗后6、12、24、48、72 h血中氧氟沙星浓度差异有统计学意义（F=2.630、3.004、3.346、3.035、2.938,P=0.007、0.011、0.019、0.020、0.017）,A组高于其他两组.结论 持续气管内滴药用于预防气管切开术后的肺部感染,疗效显著,优于雾化吸入及间歇气管内滴药治疗的临床效果.

Effect of continual endotracheal instillation in preventing tracheotomy patients from respiratory tract infection

Objective To explore the clinical effects of continual endotracheal instillation in treating tracheotomy patients, in order to avoid respiratory tract infection. Methods The clinical data of 92 patients underwent tracheotomy were retrospectively analyzed. 36 cases （group A） were treated with continual endotracheal instillation, 29 cases were treated with atomization inhalation（ group B） ,27 cases （group C） were treated with intermittent endotra- cheal instillation. The positive rate of sputum culture, plasma concentration of ofloxacin were observed in three groups. The clinical efficacy of continual endotracheal instillatiOn in preventing respiratory tract infection was analyzed. Results 3,6,9,12 days after tracheotomy, the positive rate of sputum culture in group A was significantly lower than those of B and C groups （ P = 0. 031,0. 025 ,0. 016,0. 021 ）. 6,12,24,48,72 h after treatment, the plasma concentra- tion of ofloxacin in group A was significantly higher than those in B and C groups （F = 2.630,3. 004,3. 346,3. 035, 2. 938,P = 0. 007 ,0. 011,0. 019 ,0. 020,0. 017）. Conclusion Compared with atomization inhalation and intermittent endotracheal instillation, continual endotracheal instillation showed better effects in treating patients received tracheotomy, for it could reduce the incidence of lower respiratory tract infection and help patients to recover.