高流量鼻导管氧疗联合亚胺培南西司他丁治疗重症肺炎的临床疗效
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摘要
目的:探讨高流量鼻导管氧疗联合亚胺培南西司他丁治疗重症肺炎的临床疗效。方法:随机选取2016年8月至2017年8月诊治的重症肺炎患者65例,将联合高流量鼻导管氧疗和亚胺培南西司他丁治疗的35例患者为观察组,将面罩吸氧组患者30例为对照组,观察两组患者治疗前、治疗后的临床有效率、呼吸频率、咳嗽评分、细菌清除率以及血气分析。结果:观察组患者的临床有效率77.14%,高于对照组患者的63.33%(P<0.05);治疗第10 d,观察组患者的细菌清除率为80.00%,高于对照组(P<0.05);两组的血气分析结果差异无统计学意义(P>0.05);治疗第10 d结束时,两组患者呼吸频率均减少,观察组患者与对照组比较呼吸频率减少更为明显(P<0.05)。结论:在亚胺培南西司他丁抗感染治疗基础上配合高流量鼻导管氧疗,可有效增强细菌清除率和改善临床症状,具有重要的临床价值。
Objective:To investigate the clinical effect of high flow nasal catheter oxygen therapy combined with imipenem cilastatin in the treatment of patients with severe pneumonia. Methods: A total of 65 patients with severe pneumonia who were diagnosed and treated in our hospital from August 2016 to August 2017 were selected randomly. 35 patients treated with high-flow nasal catheter oxygen therapy and imipenem cilastatin were selected as the observation group and 30 cases of oxygen-treated patients were selected as the control group. The clinical efficiency, respiratory rate, cough score, bacterial clearance and blood gas analysis were observed before and after treatment. Results: The clinical effective rate in the observation group was as high as 77.14 %, which was significantly higher than that in the control group(63.33 %)(P<0.05). On the 10 th day after treatment, the bacterial clearance rate in the observation group was 80.00 %, significantly higher than that in the control group(P<0.05). However, the results of blood gas analysis showed no significant difference between the two groups(P>0.05). At the end of the 10 th day, the respiration rates of both groups were significantly decreased. The decrease of respiratory rate was more obvious(P<0.05).Conclusion: High flow nasal catheter oxygen therapy combined with imipenem cilastatin in the treatment of patients with severe pneumonia can effectively enhance bacterial clearance and improve clinical symptoms, which has important clinical value.
Objective:To investigate the clinical effect of high flow nasal catheter oxygen therapy combined with imipenem cilastatin in the treatment of patients with severe pneumonia. Methods: A total of 65 patients with severe pneumonia who were diagnosed and treated in our hospital from August 2016 to August 2017 were selected randomly. 35 patients treated with high-flow nasal catheter oxygen therapy and imipenem cilastatin were selected as the observation group and 30 cases of oxygen-treated patients were selected as the control group. The clinical efficiency, respiratory rate, cough score, bacterial clearance and blood gas analysis were observed before and after treatment. Results: The clinical effective rate in the observation group was as high as 77.14 %, which was significantly higher than that in the control group(63.33 %)(P<0.05). On the 10 th day after treatment, the bacterial clearance rate in the observation group was 80.00 %, significantly higher than that in the control group(P<0.05). However, the results of blood gas analysis showed no significant difference between the two groups(P>0.05). At the end of the 10 th day, the respiration rates of both groups were significantly decreased. The decrease of respiratory rate was more obvious(P<0.05).Conclusion: High flow nasal catheter oxygen therapy combined with imipenem cilastatin in the treatment of patients with severe pneumonia can effectively enhance bacterial clearance and improve clinical symptoms, which has important clinical value.
引文
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[15] Katsube T,Yamano Y,Yano Y.Pharmacokinetic pharmacodynamic modeling and simulation for in vivo. bactericidal effect in murine infection model[J]. J Pharm Sci,2008,97(4):1606-1614.
[2] 崔彦芹,周娜,王燕飞,等.经鼻高流量湿化氧疗治疗先天性心脏病术后呼吸衰竭的有效性研究[J].中国呼吸唔危重监护杂志,2012,11(3):231-234.
[3] 腾寅,肖家荣,林鹏,等.血必净注射液对重症肺炎患者细胞免疫及炎症因子的影响[J].中国实验方剂学杂志,2012,18(12):295-297.
[4] 张芳.中西医结合治疗重症肺炎50例临床观察[J].中国医药指南,2014,12(13):303-304.
[5] 黄梅,韦丹,何炎志.高流量鼻导管湿化氧疗治疗新生儿重症肺炎的临床研究[J].中国医师进修杂志,2014,37(6):4-6.
[6] Ozgur ES,Horasan ES,Karaca K,et al.Ventilator-associated pneumonia due to extensive drug-resistant Acinetobacterbaumannii: risk factors,clinicalfeatures,and outcomes[J].Am J Infect Control, 2014,42(2):206-208.
[7] 王海娟,石华,周伟,等.新生儿肺炎常见病原体及临床特征分析[J].中国当代儿科杂志,2012,14(12):898-902.
[8] 李恺,王艳丽,叶秀桢,等.湿化高流量鼻导管通气在早产儿机械通气撤机中的应用研究[J].中国新生儿科杂志,2014,29(5):306-309.
[9] 郑晶晶,陈新,周露茜,等.无创正压通气对夜间慢性阻塞性肺疾病患者呼吸力学和睡眠紊乱的影响[J].中华生物医学工程杂志,2012,12(6):477-481.
[10] 唐玉红,邹佩霞.新生儿肺炎患儿行机械通气治疗的护理干预[J].使用临床医药杂志,2015,19(2):138-140.
[11] 妥建军.美罗培南治疗重症肺炎36例临床分析[J].中国乡村医药,2010,17(11):11-12.
[12] 袁壮,赵先侠.小儿重症监护病房抗生素降价梯治疗[J].中国实用儿科杂志,2003,18(4):203.
[13] 张石革,藏靖,梁建华,等.碳青霉烯类抗生素的研究进展及其在抗感染中的应用评价[J].中国医院用药评价与分析,2004,4(2):71-74.
[14] Zhanel GG, Wiebe R, Dilay L,et al. Comparative review ofthecarbapenms[J].Drugs,2007,67(7):1027-1052.
[15] Katsube T,Yamano Y,Yano Y.Pharmacokinetic pharmacodynamic modeling and simulation for in vivo. bactericidal effect in murine infection model[J]. J Pharm Sci,2008,97(4):1606-1614.