奥司他韦联合机械通气治疗呼吸道病毒感染合并呼吸衰竭的临床效果

Clinical effect of oseltamivir combined with mechanical ventilation in the treatment of respiratory virus infection complicated with respiratory failure

目的观察奥司他韦联合机械通气治疗呼吸道病毒感染合并呼吸衰竭的临床效果。方法纳入2019年5月—2021年5月深圳市坪山区人民医院、深圳市第三人民医院收治的经临床诊断确诊为呼吸道病毒感染合并呼吸衰竭的患者42例,以平行信封抽签方式随机分为观察组和对照组,每组21例。观察组采用奥司他韦联合机械通气治疗,对照组采用利巴韦林联合机械通气治疗,2组均治疗5 d。比较2组临床治疗效果、治疗前后红细胞沉降率(ESR)、白细胞计数(WBC)、淋巴细胞计数(LYMPH)、白介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)、退热时间、症状改善时间、住院时间及血气分析指标好转时间。结果观察组临床治疗总有效率(95.24%)高于对照组(57.14%),差异有统计学意义(χ^(2)=8.400,P=0.004);治疗5 d后,2组ESR、WBC、LYMPH、IL-6、CRP、PCT水平均低于治疗前,且观察组低于对照组(P<0.05或P<0.01);观察组退热时间、症状改善时间、住院时间及血气分析指标好转时间均短于对照组(P<0.01)。结论奥司他韦联合机械通气治疗呼吸道病毒感染合并呼吸衰竭临床治疗效果较好,可改善患者炎性因子指标,提升患者康复率。

Objective To observe the clinical effect of oseltamivir combined with mechanical ventilation in the treatment of respiratory virus infection complicated with respiratory failure.Methods 42 patients with respiratory virus infection complicated with respiratory failure treated in Shenzhen Pingshan District People′s Hospital and Shenzhen Third People′s Hospital from May 2019 to May 2021 were randomly divided into observation group and control group by parallel envelope lottery,21 cases in each group.The observation group was treated with oseltamivir combined with mechanical ventilation,and the control group was treated with ribavirin combined with mechanical ventilation,both groups were treated for 5 days.The clinical treatment effect,ESR,WBC,LYMPH,IL-6,CRP,PCT,antipyretic time,symptoms improve time,hospitalization time and blood gas analysis index turnaround time were compared between the two groups.Results The total effective rate of clinical treatment in the observation group(95.24%)was higher than that in the control group(57.14%),the difference was statistically significant(χ^(2)=8.400,P=0.004);After 5 days of treatment,the levels of ESR,WBC,LYMPH,IL-6,CRP and PCT in the two groups were lower than those before treatment,and those in the observation group were lower than those in the control group(P<0.05 or P<0.01);The antipyretic time,symptoms improve time,hospitalization time and blood gas analysis index turnaround time in the observation group were shorter than those in the control group(P<0.01).Conclusion Oseltamivir combined with mechanical ventilation is effective in the treatment of respiratory virus infection complicated with respiratory failure,it can improve the indexes of inflammatory factors and improve the rehabilitation rate of patients.