目的 探討鹽酸氨溴索注射對腦外傷氣管切開術(shù)后患者呼吸道感染的療效。方法 將2008年4月—2013年12月來上海中醫(yī)藥大學附屬曙光醫(yī)院就診的76例接受氣管切開術(shù)的顱腦外傷患者隨機分為治療組（38例）和對照組（38例）。對照組接受支氣管肺泡灌洗，治療組在對照組的基礎(chǔ)上于氣管切開第1天起iv鹽酸氨溴索30 mg+18 mL生理鹽水，3次/d，每次間隔8 h，連續(xù)使用1周。對比分析兩組患者氣管切開后呼吸道的感染及控制情況。結(jié)果 第5、7天，治療組肺泡灌洗液中白細胞個數(shù)明顯少于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。第3、5、7天，治療組肺泡灌洗液中多形核細胞數(shù)明顯少于對照組，兩組比較差異有統(tǒng)計學意義（P<0.05）。氣管切開1個月后，治療組和對照組呼吸道感染發(fā)生率分別為60.5%、92.1%，兩組比較差異有統(tǒng)計學意義（P<0.05）。兩組感染控制率分別為82.6%、57.1%，兩組比較差異有統(tǒng)計學意義（P<0.05）。結(jié)論 鹽酸氨溴索注射液聯(lián)合肺泡灌洗對腦外傷氣管切開術(shù)后患者呼吸道感染的療效顯著，值得推廣。

Objective To explore the efficacy of Ambroxol Hydrochloride Injection in treatment of respiratory infection after tracheotomy of traumatic brain injury. Methods Patients with tracheostomy (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 Hydrochloride Injection 30 mg added into 18 mL saline, three times daily, each time interval of 8 h, and continuous used for 1 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.

國家自然科學基金資助項目（30971173）