气道内微泵推注敏感抗生素效果监测及分析

目的：监测气管切开术后痰培养致病菌阳性病人气道内微泵推注敏感抗生素的效果。方法：将60例病人随机分为两组，均用微泵推注湿化液。观察组（30例）气道内微泵推注湿化液为生理盐水加α-糜蛋白酶加敏感抗生素；对照组（30例）气道内湿化液用生理盐水加α-糜蛋白酶，比较两组痰量、分泌物粘稠度、发热天数、痰培养致病菌检出率。结果：两组病人痰量比较，治疗前差异无显著性意义（P＞0．05），用药后第3、7天观察组比对照组明显减少（均P＜0．05）；气道分泌物粘稠度降低病例数比较,观察组明显多于对照组（P＜0．05）；治疗后痰培养致病菌检出率比较，观察组明显低于对照组（P＜0．05）；两组发热天数比较，差异无显著性意义（P＞0．05）。结论：气管切开术后在气道湿化液中加用敏感抗生素可使痰量减少，呼吸道分泌物粘稠度降低，痰培养致病菌检出率下降，可有效防治下呼吸道感染。

Effectiveness of Sensitive Antibiotics Micro-pump Infusion via Airway Post-tracheotomy

Objective To evaluate the effectiveness of sensitive antibiotics micro pump infusion via airway post tracheotomy in the patients with positive pathogens of sputum culture.Methods Sixty patients were divided into two groups both receiving humidified solution infused by a micro pump. In the observation group ( n =30): micro pump infusion of humidified solution, normal saline, alpha chymotrypsin and sensitive antibiotics via airway; In the control group ( n =30): micro pump infusion of humidified solution, normal saline and alpha chymotrypsin. The sputum volume, viscosity of the secretion, the fever days, the changes in detectable rate of the pathogens in sputum culture were compared between the two groups. Results The sputum volume at 3 th and 7 th day after treatment in the observation group was significantly decreased as compared with that in the control group ( P <0 05). The cases of the decreased viscosity of airway secretion in the observation group were more than in the control group ( P <0 05). After treatment, the detectable rate of the pathogens in the sputum culture in the observation was lower than in the control group ( P <0 05). There was no significant difference in the fever days between the two groups ( P >0 05). Conclusion Addition of sensitive antibiotics in the humidified solution of airway post tracheotomy can reduce the sputum volume, decrease the viscosity of the airway secretion and lower the detectable rate of the pathogens in sputum culture.