肺炎疫苗联合流感疫苗在呼吸内科老年患者中的应用

Application of pneumonia vaccine combined with influenza vaccine on elderly patients in department of respiratory

目的：探讨肺炎疫苗联合流感疫苗在呼吸内科老年患者中的应用。方法选取2011年4月-2013年4月桂林市博爱医院呼吸内科收治的80例老年患者,按照随机数字表法分为对照组和疫苗组,每组各40例。对照组采用常规治疗护理,疫苗组在常规治疗护理基础上于观察期开始肌注肺炎疫苗1次（0.5 mL）,并于每年流感流行季节到来前2周常规肌注流感疫苗1次（0.5 mL）,80例患者出院后,同期每2周随访1次,连续追踪2年,询问患者随访期间咳嗽、咳痰、气喘、咯血等症状,作出临床评价,观察比较两组患者的症状发作次数、住院次数、住院时间、再次症状发作间隔时间、感染流感的次数、感染肺炎链球菌肺炎次数、继发肺部真菌感染次数及患者病死数。结果经2年观察,疫苗组患者的症状发作次数、住院次数、住院时间、感染流感的次数、感染肺炎链球菌肺炎次数、继发肺部真菌感染次数、真菌耐药次数及病死率均少于对照组[（2.74±1.59）比（5.88±2.18）次、（1.00±0.53）比（2.24±0.92）次、（7±4）比（19±8）d、（13.00±2.06）比（161.00±25.46）次、（16.00±2.53）比（148.00±23.4）次、（5.00±0.79）比（21.00±3.32）次、（8.00±1.26）比（29.01±4.86）次、2.5豫比15.0豫],差异有统计学意义（P〈0.05）；疫苗组患者再次症状发作间隔时间较对照组延长,差异有统计学意义（P〈0.05）。结论给呼吸内科老年患者注射肺炎疫苗联合流感疫苗能减少感染流感、肺炎链球菌肺炎、继发肺部真菌感染,降低真菌耐药,减少症状发作,缩短住院时间,延长症状发作间隔时间,降低病死率等优点,值得临床进一步推广应用。

Objective To explore the application of pneumonia vaccine combined with influenza vaccine on elderly pa-tients in department of respiratory. Methods From April 2011 to April 2013, in Department of Respiratory, Guilin Bo＇ai Hospital, 80 elderly patients were selected, according to random number table, they were divided into control group and vaccine group, with 40 cases in each group. The control group were give nconventional treatment and nurs-ing, while the vaccine group were given on the basis of conventional treatment and nursing intramuscular injection of pneu-monia vaccine intramuscularly once （0.5 mL） at the beginning of the observation period, and influenza vaccine （0.5 mL） in 2 weeks before the flu season each year. After 80 patients were discharged, follow-up of one time each two weeks, tracking two years. Symptoms of cough, sputum, wheezing, hemoptysis and others were asked and clinical evaluation were made. The target indexes of symptom episodes,number of hospitalizations, hospitalization time, again the onset of symptoms interval, influenza infection, pneumococcal pneumonia infection, secondary pulmonary fungi infection and dead patients were observed. Results After observed two years, number of symptoms episodes, number of hospitaliza-tions, hospitalization time, number of influenza infection, number of pneumococcal pneumonia infection, number of sec-ondary pulmonary fungi infection, number of fungi drug resistance and mortality rate in vaccine group were lower than those in control group [（2.74±1.59） v s （5.88±2.18） times,＆nbsp;（1.00±0.53） vs （2.24±0.92） times, （7±4） vs （19±8） d, （13.00±2.06） vs （161.00±25.46） times, （16.00±2.53） vs （148.00±23.4） times, （5.00±0.79） vs （21.00±3.32） times, （8.00±1.26） vs （29.01±4.86） times, 2.5%vs 15.0%], the differences were statistically significant （P〈 0.05）. The time of again the onset of symptoms interval in in vaccine group were longer than that in control group, the difference was statistically significant （P〈 0.05）. Conclusion Elderly patients treated pneumonia vaccine combined influenza vaccine can reduce the times of influenza, pneumococcal pneumonia, secondary pulmonary fungal infections, fungal resistance, shorten the number of days of symptom onset and the average hospital-ization time and prolong the interval time of symptom onset. In terms of reducing the number of deaths and so on, it is worthy of further clinical application.