ABSTRACT
Objective To investigate the effect of enteral microecopharmaceutics nutrition supplement (EMN) on incidence of ventilator associated pneumonia complications,inflammatory responses,and prognoses in patients with severe traumatic brain injury (sTBI) undergoing ventilator therapy.Methods From January 2016 to September 2017,70 patients with sTBI were randomly divided into an experimental group (EMN supplement,n=35) and a control group (n=35).Early enteral nutrition was given to patients from both groups,and bifidobacterium viable capsule was given to patients from the experimental group.Glasgow Coma Scale (GCS) scores,acute physiological and chronic health evaluation (APACHE) II scores,number of white blood cells (WBC),proportion of neutrophil (N),and serum levels of procalcitonin (PCT) and C-reactive protein (CRP) were compared between the two groups on admission and 14 d after treatment.The incidence of VAP and clinical pulmonary infection scale (CPIS) scores,pulmonary function,mechanical ventilation time and hospital stays were compared 14 d after treatment.Results The incidence of VAP in the experimental group (n=17,51％) 14 d after EMN supplement was significantly lower as compared with that in the control group (n=22,63％,P＜0.05).Meanwhile,VAP patients from the experimental group had significantly lower CPIS scores as compared with patients from control group (P＜0.05).Ventilator weaning was achieved in 29 patients from experimental group (83％) and 24 patients from control group (69％),with significant difference (P＜0.05);ventilator weaning patients from the experimental group had significantly improved lung function as compared with ventilator weaning patients from control group (P＜0.05).WBC number,N proportion,and serum PCT and CRP levels in the experimental group were significantly smaller/decreased as compared with those in the control group (P＜0.05).As compared with patients from control group,patients from the experimental group had significantly higher GCS scores (8.35±0.51 vs.9.48±0.48,P＜0.05) and significantly lower APACHE II scores (12.58±0.78 vs.14.68±0.97,P＜0.05).Conclusion EMN supplement can effectively reduce the VAP incidence,alleviate the degree of infection and inflammatory response in patients with sTBI undergoing ventilator therapy,therefore,improve the prognosis;this method is worth of promotion.
ABSTRACT
AIM: To compare the therapeutic effects and adverse reactions of nicardipine and labetalol injection in treating acute and severe hypertensions. METHODS: Sixty-seven patients in nicardipine group (M 46, F 21; age 52 a± s 11 a) were given nicardipine 2 mg in 0.9 % sodium chloride or 5 % glucose injection 10 mL within 2 min iv, first, and then given 30 mg nicardipine in 0.9 % sodium chlocide or 5 % glucose injection 250 mL by continual intravenous infusion for 6 h. Sixty-one patients in labetalol group (M 41, F 20; age 53 a±9 a) received 50 mg labetalol in 5 % glucose injection 20 mL by intravenous once. The treatment could be repeated every 15 min, in case it was less effective, but the total dose should be no more than 200 mg. RESULTS: The treatment for the nicardipine group and the labetalol group, reached the marked effect within 5 min. The total marked effective rate was all 100 % (P>0.05). Severe adverse reactions occured in the two patients (one occured significantly lowering of blood pressure, and the other aggravated asthma) in the labetalol group. CONCLUSION: Intravenous nicardipine and labetalol are fast and smooth in reducing the blood pressure of the patients with acute and severe hypertension, but the safety of nicardipine is superior to that of labetalol