重症肺部感染患者不同激素辅助治疗的临床研究

Clinical comparative study on different hormone adjuvant therapies for patients with severe pulmonary infections

目的探讨地塞米松、氢化可的松、甲泼尼龙辅助治疗重症肺部感染的临床效果,以期提高临床治疗水平。方法随机选取2011年2月-2013年4月99例严重外伤后重症肺部感染患者为研究对象,分成3组,每组各33例,均在对症、抗感染等治疗的基础上分别予以地塞米松、氢化可的松、甲泼尼龙辅助治疗,观察治疗后临床效果差异性,数据采用SPSS13.0软件进行分析。结果地塞米松组的治愈率为27.27%,总有效率为69.69%;氢化可的松组的治愈率为30.31%,总有效率为75.76%,甲泼尼龙组的治愈率为69.7%,总有效率为93.94%;地塞米松组与氢化可的松组比较差异无统计学意义,甲泼尼龙组与其他两组比较差异有统计学意义(P<0.05);地塞米松组与氢化可的松组咳嗽、咳痰消失时间等症状改善以及第一秒最大呼气量和最大呼气流速峰值等肺功能比较差异无统计学意义,甲泼尼龙组与以上两组在各项指标中比较则差异均有统计学意义(P<0.05)。结论甲泼尼龙辅助治疗并发重症肺部感染临床效果较满意,但是要严格掌握适应证。

OBJECTIVE To investigate clinical effects of dexamethasone injection （dexamethasone）, injection of hydrocortisone sodium succinate （hydrocortisone）, injection of methylprednisolone sodium succinate （methylpred- nisolone） in adjuvant therapy for severe pulmonary infections, in order to improve the level of clinical treatment. METHODS Totally 99 cases of patients with severe pulmonary infections after severe trauma in Feb. 2011-Apr. 2013 were randomly selected and divided into three groups of 33 patients each and received dexamethasone, hydro- cortisone, methylprednisolone adjuvant therapies based on symptomatic treatment and anti-infection treatment, the differences in the clinical effects were observed after treatment. Data were analyzed by SPSS 13.0. RESULTS For clinical effects, dexamethasone cure rate was 27.27%, total effective rate was 69.69%; cure rate in hydrocortisone group was 30.31%, total effective rate was 75. 76% cure rate in methylprednisolone group was 69.7%, total effective rate was 93.94%. Comparison of dexamethasone and hydrocortisone groups showed no significant difference, comparison of methylprednisolone group and the other two groups had significant difference （P〈0.05）. Comparison of dexamethasone injection group and hydrocortisone injection group in improved symptoms such as cough and sputum disappearance time, forced expiratory volume in one second, peak expiratory flow, and other lung functions showed no significant difference, but for the methylprednisolone group and the above two sets of indicators in the above comparison, there were significant differences （P〈0.05）. CONCLUSION Methylpred- nisolone adjuvant therapy for treatment of complicated severe pulmonary infection has relatively satisfactory clinical results, but the indications must be strictly controlled.