气管内冲洗在新生儿呼吸机相关肺炎中的应用

林新祝, 欧阳长安, 赖基栋, 李雅丹, 郑直

中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (3) : 195-197.

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中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (3) : 195-197.
论著·临床研究

气管内冲洗在新生儿呼吸机相关肺炎中的应用

  • 林新祝,欧阳长安,赖基栋,李雅丹,郑直
作者信息 +

Application of endotracheal lavage in neonatal ventilator-associated pneumonia

  • LIN Xin-Zhu, OU Yang-Chang-An, LAI Ji-Dong, LI Ya-Dan, ZHENG Zhi
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文章历史 +

摘要

目的:探讨气管内冲洗技术在新生儿呼吸机相关肺炎(VAP)中的应用。方法:将2002年1月至2008年12月新生儿VAP 58例,随机分为对照组29例,冲洗组29例。两组撤机后,根据痰培养及药敏结果给予敏感抗生素治疗并加强对症支持处理。冲洗组在对照组治疗的基础上,应用气管内冲洗治疗,每日2~3次。对两组的治疗效果进行比较。结果:对照组平均机械通气时间与冲洗组差异无统计学意义;对照组治疗有效率为69%,冲洗组为93%,差异有统计学意义(P<0.05);对照组二次或多次上呼吸机比例为24%,冲洗组为3%(P<0.05);冲洗组冲洗后2 h的血气分析结果明显优于冲洗前(P<0.01)。结论:气管内冲洗可以减少患儿机械通气的次数,提高治疗有效率,值得临床推广应用。[中国当代儿科杂志,2010,12(3):195-197]

Abstract

OBJECTIVE: To study the efficacy of endotracheal lavage in neonatal ventilator-associated pneumonia (VAP). METHODS: Fifty-eight neonates with VAP between January 2002 and December 2008 were randomly assigned to two groups: lavage and control (n=29 each). After withdrawal from ventilator, both groups received sensitive antibiotics therapy according to sputum culture results as well as supportive treatment. The lavage group was additionally treated with endotracheal lavage (2-3 times daily). The therapeutic effects were compared between the two groups. RESULTS: There were no significant differences in the average time of mechanical ventilation between the lavage and the control groups. The effective rate in the lavage group (93%) was significantly higher than that in the control group (69%; P<0.05). Three percent of patients in the lavage group required twice or more mechanical ventilation compared with 24% in the control group (P<0.05). Blood gas analysis results were obviously improved in the lavage group 2 hrs after treatment (P<0.01). CONCLUSIONS: Endotracheal lavage can decrease the number in mechanical ventilation and improve therapeutic effects in neonates with VAP.[Chin J Contemp Pediatr, 2010, 12 (3):195-197]

关键词

呼吸机相关肺炎 / 机械通气 / 新生儿

Key words

Ventilator-associated pneumonia / Mechanical ventilation / Neonate

引用本文

导出引用
林新祝, 欧阳长安, 赖基栋, 李雅丹, 郑直. 气管内冲洗在新生儿呼吸机相关肺炎中的应用[J]. 中国当代儿科杂志. 2010, 12(3): 195-197
LIN Xin-Zhu, OU Yang-Chang-An, LAI Ji-Dong, LI Ya-Dan, ZHENG Zhi. Application of endotracheal lavage in neonatal ventilator-associated pneumonia[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(3): 195-197
中图分类号: R722   

参考文献

[1]薛辛东,杜立中,孙眉月. 新生儿机械通气常规[J]. 中华儿科杂志,2004,42(5):356-357.
[2]曹毅民,郭在晨.呼吸机相关肺炎的诊断技术[J]. 中华儿科杂志,2002,40(7):426-428.
[3]Kurachek SC, Newth CJ, Quasney MW, Morin FC, Shaffer TH, Rubenstein SD, et al. Extubation failure in pediatric intensive care:a multiple-center study of risk factors and outcomes[J].Crit Care Med, 2003, 31(11):2657-2664.
[4]夏耀方,刘翠青,时会菊,马莉.新生儿呼吸窘迫综合征合并呼吸机相关肺炎患儿气道灌洗液IL-4和IL-13水平监测[J]. 中国当代儿科杂志,2009,11(8):645-648.


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