呼吸机联合激素及丙种球蛋白治疗重症肺炎的效果研究

Study on the effect of ventilator combined with hormone and gamma globulin on severe pneumonia

目的了解重症肺炎患者采用呼吸机联合激素及丙种球蛋白治疗的效果。方法70例重症肺炎患者,随机分为常规治疗组和联合治疗组,每组35例。常规治疗组患者给予常规治疗,联合治疗组患者给予呼吸机联合激素及丙种球蛋白治疗。比较两组患者治疗效果;咳嗽症状消失时间、血清炎症指标恢复正常时间、咳痰消失时间、肺部湿啰音消失时间;治疗前后血气分析指标、肺部炎症指标以及肺功能指标;呼吸机相关性肺炎发生情况。结果联合治疗组患者的治疗总有效率为100.00%,高于常规治疗组的77.14%,差异具有统计学意义(P<0.05)。治疗后,联合治疗组患者氧分压(PaO2)、二氧化碳分压(PaCO2)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)水平均优于常规治疗组,差异具有统计学意义(P<0.05)。治疗后,联合治疗组患者用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、呼气峰值流速(PEF)均高于常规治疗组,差异具有统计学意义(P<0.05)。联合治疗组咳嗽症状消失时间、血清炎症指标恢复正常时间、咳痰消失时间、肺部湿啰音消失时间分别为(8.24±1.45)、(9.11±1.21)、(8.24±1.41)、(10.21±2.21)d,均短于常规治疗组的(10.34±1.67)、(11.45±1.67)、(10.78±1.89)、(12.78±2.78)d,差异具有统计学意义(P<0.05)。联合治疗组患者呼吸机相关性肺炎发生率为2.86%(1/35),低于常规治疗组的25.71%(9/35),差异具有统计学意义(P<0.05)。结论重症肺炎患者实施呼吸机联合激素及丙种球蛋白治疗效果确切,可有效改善患者血气分析指标,并提高肺功能,控制肺部炎症,缩短住院时间,减少呼吸机相关性肺炎的发生。

Objective To understand the effect of ventilator combined with hormone and gamma globulin on severe pneumonia.Methods A total of 70 severe pneumonia patients were randomly divided into conventional treatment group and combined treatment group,with 35 cases in each group.Patients in the conventional treatment group received conventional treatment,while patients in the combined treatment group received ventilator combined with hormone and gamma globulin treatment.The therapeutic effect,disappearance time of cough,time for serum inflammation index to return to normal,disappearance time of expectoration and lung moistrale,blood gas analysis index,lung inflammation index and lung function index before and after treatment,and occurrence of ventilator associated pneumonia were compared between the two groups.Results The total effective rate of treatment of combined treatment group was 100.00%,which was higher than that of the conventional treatment group 77.14%,and the difference was statistically significant(P<0.05).After treatment,the levels of partial pressure of oxygen(PaO2),partial pressure of carbon dioxide(PaCO2),tumor necrosis factor-α(TNF-α),high sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6)of the combined treatment group were better than those of the conventional treatment group,and the difference was statistically significant(P<0.05).After treatment,the forced vital capacity(FVC),forced expiratory volume(FEV1)in the first second,peak expiratory flow(PEF)of the combined treatment group were higher than those of the conventional treatment group,and the difference was statistically significant(P<0.05).The disappearance time of cough,time for serum inflammation index to return to normal,disappearance time of expectoration and lung moistrale of the combined treatment group were(8.24±1.45),(9.11±1.21),(8.24±1.41)and(10.21±2.21)d,which were shorter than those of the conventional treatment group (10.34±1.67), (11.45±1.67), (10.78±1.89) and (12.78±2.78) d, and the difference was statistically significant (P<0.05). The incidence of ventilator associated pneumonia of combined treatment group was 2.86%(1/35), which was lower than that of the conventional treatment group 25.71%(9/35), and the difference was statistically significant (P<0.05). Conclusion Ventilator combined with hormone and gamma globulin shows affirmative effect on severe pneumonia, which can effectively improve blood gas analysis index, improve lung function, control lung inflammation, shorten hospitalization time, and reduce the occurrence of ventilator-associated pneumonia.