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前瞻性研究探讨了机械通气超过72小时的患者,局部应用非吸收性抗菌素对呼吸系细菌移生和感染的预防作用.研究对象为来自西班牙两家医院ICU 的28例患者.原发病均为非感染性呼吸衰竭,需长期机械通气者.入院时病情按APACHE Ⅱ系统分类.将上述病例随机分入实验组(13例)和对照组(15例)实验组每隔6小时在患者颊粘膜和口咽腔涂上4g 含有2%多粘菌素E、2%二性霉素B 和2%妥布霉素的软膏.对照组病例则用同样方法,在口咽部涂上不合抗菌素的软膏.结果应用抗菌膏的实验组13例中10例未发生院内继发性呼吸系感染,而对照组15例中,仅有1例未发生(P<0.001)。实验组中3例(23%)出现化脓性气管支气管炎,无1例发生院内肺炎,而对照组中3例(20%)出现化脓性气管支气管炎,73%出现院
In a prospective study of patients with mechanical ventilation over 72 hours, topical application of non-absorbable antibiotics for prevention of respiratory bacterial translocation and infection was performed in 28 patients from two ICU hospitals in Spain.The primary disease was Non-infectious respiratory failure, requiring long-term mechanical ventilation were admitted to the hospital according to APACHE Ⅱ system classification.The above cases were randomly divided into experimental group (13 cases) and control group (15 cases) experimental group every 6 hours in patients with buccal mucosa And oropharyngeal cavity coated with 4g containing 2% polymyxin E, 2% amphotericin B and 2% tobramycin ointment in the control group of patients in the same way, coated with antibiotic in the oropharynx Ointment.Results In the experimental group with antimicrobial cream, no secondary nosocomial respiratory infection occurred in 13 of the 13 patients, while only 1 of the 15 patients in the control group did not (P <0.001). In the experimental group, purulent tracheobronchitis occurred in 3 patients (23%), nosocomial pneumonia did not occur in 1 patient, and purulent bronchitis was found in 3 patients (20%) in the control group, and 73%