液体管理对重症肺炎肺部感染患者肺保护作用的临床研究

Clinical study of liquid management on lung protection in severe pneumonia patients with pulmonary infection

目的观察液体管理在重症肺炎肺部感染患者中的应用及对肺保护的作用。方法 60例重症肺炎肺部感染患者,随机分为对照组和观察组,各30例。对照组采用常规方法治疗,观察组在对照组基础上调整液体输注并进行液体管理,采用酶联免疫吸附试验监测肺组织炎症因子,比较两组临床疗效及对肺保护的作用。结果两组治疗前[白细胞介素-6(IL-6)、氧分压(Pa O2)、肺泡-动脉氧分差P(A-a)O2]水平比较差异无统计学意义(P>0.05);观察组治疗后IL-6水平、P(A-a)O2低于对照组,Pa O2水平高于对照组,差异有统计学意义(P<0.05);治疗后通过胸部螺旋CT检查发现观察组有效率为90.00%,明显高于对照组的43.33%,差异有统计学意义(P<0.05)。结论重症肺炎肺部感染患者在常规治疗基础上联合液体管理效果理想,能实现肺保护作用,提高临床治疗效果,值得推广应用。

Objective To observe the application of liquid management in severe pneumonia patients with pulmonary infection and its effect on lung protection. Methods A total of 60 patients with severe pneumonia and lung infection were randomly divided into control group and observation group, with 30 cases in each group. The control group received conventional methods for treatment, and the observation group also received adjusted liquid infusion and liquid management. The inflammatory factors of lung tissue were monitored by enzyme linked immunosorbent assay, and comparison were made on clinical curative effect and lung protection effect in two groups. Results Both groups had no statistically significant difference in interleukin-6（IL-6）, oxygen partial pressure（PaO2）, alveoli-arterial oxygen difference P（A-a）O2 level before treatment（P〈0.05）. After treatment, the observation group had lower IL-6 level and P（A-a）O2 than the control group, and higher PaO2 level than the control group. Their difference had statistical significance（P〈0.05）. The observation group had obviously higher effective rate by chest spiral CT scan as 90.00% after treatment, which was obviously higher than 43.33% in the control group, and the difference had statistical significance（P〈0.05）. Conclusion Combination of conventional treatment and liquid management shows ideal effect in severe pneumonia patients with pulmonary infection, and it can achieve effect of lung protection, and improve the clinical effect. So it is worthy of popularization and application.