危重病员容易引起医院内感染,其病原菌大多为内源性的,即病员口咽部和消化道内的细菌,主要包括肠杆菌科细菌、假单胞菌和酵母菌。为了确定阻止重危病员的菌群失调能否防止革蓝氏阴性菌感染,作者进行了一前瞻性随机研究。96名重点护理的病员随机分为对照组和研究组,分别为47和49名。研究组的病员除了静脉投用头孢噻肟(50～70mg/kg.d)5～7天外,均在颊部粘膜上每6小时局部使用羧甲基纤维素钠糊剂(多粘菌素E、妥布拉霉素和两性霉素B的含量均为2%);鼻饲管内每6小时注射200mg多粘菌素E、80mg妥布拉霉素和500mg两性霉素B混悬液。二组 Critically ill patients can easily cause nosocomial infections. Most of their pathogens are endogenous, ie, bacteria in the oropharynx and the digestive tract of patients, including Enterobacteriaceae, Pseudomonas and yeast. In order to determine whether blocking the flora of critically ill patients can prevent Gram-negative infections, the authors conducted a prospective randomized study. Ninety-six patients with key care were randomly assigned to control and study groups, 47 and 49 respectively. Patients in the study group were given topical sodium carboxymethylcellulose paste every 6 hours on the buccal mucosa except for intravenous cefotaxime (50-70 mg / kg.d) for 5 to 7 days (polymyxin E , Tobramycin and amphotericin B were both present in 2%); a suspension of 200 mg of polymyxin E, 80 mg of tobramycin and 500 mg of amphotericin B was injected every 6 hours in the feeding tube. Two groups