糖皮质激素在老年重症社区获得性肺炎治疗中的临床价值

Clinical Value of Glucocorticoids in the Treatment of Elderly Patients With Severe Community Acquired Pneumonia

目的探究应用糖皮质激素治疗老年重症社区获得性肺炎的疗效。方法选取本院重症医学科收治的98例重症社区获得性肺炎患者,分为实验组(糖皮质激素治疗)对照组(抗生素治疗),实验组50例,对照组48例,观察两组治疗效果。结果实验组Pa O2为(60.23±11.41)mm Hg,Pa O2/Fi O2为(201.2±60.2);对照组分别为(69.52±13.5)mm Hg、(296±60.5),差异具有统计学意义,P<0.05;两组在体温正常、咳嗽缓解、气急缓解、啰音消失时间对比无统计学意义(P>0.05),在Pa O2升高、住院时间上差异具有统计学意义(P<0.05);两组不良反应对比,差异均无统计学意义(P>0.05)。结论应用糖皮质激素治疗重症CAP患者,体温以及氧合改善明显,但住院时间比抗生素治疗更长,糖皮质激素类药物剂量与疗效还需要进一步研究。

Objective To explore the therapeutic effect of glucocorticoid in the treatment of severe community acquired pneumonia in elderly patients. Methods A total of 98 patients with severe community admitted to ICU of the hospital acquired pneumonia patients were divided into experimental group（glucocorticoid therapy） and control group（antibiotic treatment）,50 cases in the experimental group,48 cases in the control group,observe the treatment effect of the two groups. Results The experimental group Pa O_2（60.23±11.41） mm Hg,Pa O_2/Fi O_2（201.2±60.2）,the control group respectively（69.52±13.5） mm,Hg（296±60.5）,the difference was statistically significant,P〈0.05,two groups in normal temperature,cough relieving,shortness of breath,rales contrast ease no statistical significance（P〉0.05）,the rise in Pa O_2,hospitalization time difference was statistically significant（P〈0.05）,adverse reactions of the two groups were compared,there were no significant differences（P〉0.05）. Conclusion The use of corticosteroids in the treatment of patients with severe CAP,body temperature and oxygenation improved significantly,but the length of stay in hospital was longer than that of antibiotics,and the dose and efficacy of glucocorticoid drugs still need to be further studied.