摘要
目的:研究床边支纤镜吸痰与灌洗联合大剂量免疫球蛋白对有创机械通气重症肺炎的疗效。方法:选取2015年1月-2017年3月于本院接受有创机械通气的重症肺炎患者82例,根据随机数字表法分为观察组及对照组,每组41例。对照组给予常规治疗,观察组则在对照组的基础上给予床边支纤镜吸痰与灌洗联合大剂量免疫球蛋白治疗。分别比较治疗前后两组PCT、hs-CRP、PaO_2、PaCO_2水平,机械通气时间、住院时间、并发症发生及病死情况。结果:治疗后观察组PCT、hs-CRP水平分别为(0.2±0.1)μg/L、(6.0±5.3)mg/L,低于对照组的(0.5±0.3)μg/L、(10.3±8.1)mg/L,差异均有统计学意义(P<0.05)。治疗后观察组Pa O2水平高于对照组,而PaCO_2水平低于对照组,机械通气时间、住院时间均短于对照组,差异均有统计学意义(P<0.05)。观察组并发症发生率、病死率分别为7.32%、2.44%,均低于对照组的29.27%、17.07%,差异均有统计学意义(P<0.05)。结论:床边支纤镜吸痰与灌洗联合大剂量免疫球蛋白可有效改善有创机械通气重症肺炎患者的炎症反应以及肺通换气功能,有利于促进患者早日康复,预后较好。
Objective： To study the curative effect of bedside fiber lens sputum suction and irrigation combined high-dose immunoglobulin for severe pneumonia patients with invasive mechanical ventilation. Method： From January 2015 to March 2017, 82 severe pneumonia patients undergo invasive mechanical ventilation in our hospital were selected and divided into the observation group and the control group according to random number table method, 41 patients in each group.The control group was given conventional therapy, while the observation group was given bedside fiber lens sputum suction combined irrigation with high-dose immunoglobulin therapy on the basis of the control group.PCT, hs-CRP, PaO2, PaCO2 level, mechanical ventilation time, length of hospital stay, complications and moaality of two groups before and after the treatment were compared.Result： After treatment, PCT, hs-CRP levels of the observation group after treatment were （0.2＋0.1） μg/L, （6.0＋5.3） rag/L, lower than those of the control group （0.5＋0.3） μg/L, （ 10.3~8.1 ） mg/L, the differences were statistically significant （ P〈0.05 ） .PaO2 of the observation group was higher than that of the control group, and PaCO2 was lower than that of the control group, the differences were statistically significant （ P〈0.05 ） .The mechanical ventilation time, hospital stay length of observation group were lower than those of the control group, the differences were statistically significant （P〈0.05）, the complications and mortality of the observation group were 7.32% and 2.44%, lower than those of the control group 29.27%, 17.07%, the differences were statistically significant （P〈0.05） .Conclusion： Bedside fiber lens sputum suction combined irrigation coordinated high-dose immunoglobulin can improve the inflammatory response and pulmonary ventilation function of severe pneumonia patients with invasive mechanical ventilation effectively, promote patients recover early and help them has a good prognosis.
作者
陈文标
潘淘涛
老成暖
江美嫦
关健明
汤爱玲
CHEN Wen-biao PAN Tao-tao LAO Cheng-nuan et al(The Sixth People＇s Hospital in Nanhai District of Foshan City, Foshan 528248, Chin)
出处
《中国医学创新》
CAS
2017年第23期13-16,共4页
Medical Innovation of China
基金
佛山市卫生和计生局医学科研课题(2015089)
关键词
重症肺炎
有创机械通气
床边纤维支气管镜
免疫球蛋白
Severe pneumonia
Invasive mechanical ventilation
Bedside fiber bronchoscope
Immune globulin
