心衰合并肺部感染患者联合正压通气治疗并监测血清降钙素原水平的临床应用价值

Clinical Application Value of Combined Positive Pressure Ventilation Therapy and Monitoring of Serum Procalcitonin Level in Patients with Heart Failure and Pulmonary Infection

目的:观察分析心衰合并肺部感染患者联合正压通气治疗并监测血清降钙素原水平的临床应用价值。方法:选择2020年6月-2021年6月在潍坊市坊子区人民医院接受治疗的心衰合并肺部感染患者83例,按随机数字表法将其分为观察组(n=43)与对照组(n=40),两组均临床接受常规对症治疗,其中对照组在此基础上接受鼻导管或面罩吸氧+常规抗感染治疗,观察组在此基础上接受无创正压通气(NIPPV)+根据血清降钙素原(PCT)水平监测结果指导抗感染方案治疗,治疗后判定两组临床疗效,监测其24 h临床指标及治疗前后炎性指标变化,并记录比较两组抗感染治疗时间、住院时间及二重感染发生情况。结果:治疗后,观察组总有效率(93.02%)显著高于对照组(67.50%)(P<0.05);治疗前,两组HR、RR、MAP、PO;、SpO;指标比较差异无统计学意义(P>0.05),治疗后,两组HR、RR、MAP指标显著低于治疗前,且观察组显著低于对照组(P<0.05),治疗后,两组PO;、SpO;指标显著高于治疗前,且观察组显著高于对照组(P<0.05);治疗前,两组血清CRP、ESR指标比较差异无统计学意义(P>0.05),治疗后,两组血清CRP、ESR指标显著低于治疗前,且观察组显著低于对照组(P<0.05);治疗后,观察组抗感染治疗时间、住院时间显著短于对照组(P<0.05),观察组二重感染发生率(2.32%)显著低于对照组(17.50%)(P<0.05)。结论:心衰合并肺部感染患者联合正压通气治疗并监测血清降钙素原水平指导抗感染治疗效果确切,可明显改善患者临床症状体征,抑制相应炎症反应,缩短抗感染治疗时间及住院时间,还可有效降低二重感染风险,因此值得推广应用。

Objective:To observe and analyze the clinical application value of combined positive pressure ventilation therapy and monitoring of serum procalcitonin levels in patients with heart failure and pulmonary infection.Method:A total of 83 patients with heart failure and pulmonary infection who were treated in Weifang Fangzi District People’s Hospital from June 2020 to June 2021 were selected and divided into observation group(n=43)and control group(n=40)by random number table method.Both groups received routine symptomatic treatment.The control group received nasal catheter or mask oxygen inhalation+conventional anti-infective therapy on this basis,and the observation group received non-invasive positive pressure ventilation(NIPPV)on this basis.The monitoring results of procalcitonin(PCT)levels guided the anti-infective treatment.The clinical efficacy of the two groups was determined after treatment,and the changes in the 24-hour clinical indicators and the changes in inflammatory indicators before and after the treatment were monitored.Length of hospitalization,anti-infective treatment time and occurrence of secondary infection were recorded and compared between the two groups.Result:After treatment,the total effective rate of the observation group(93.02%)was significantly higher than that of the control group(67.50%)(P<0.05).Before treatment,there were no significant differences in HR,RR,MAP,PO;,SpO;between the two groups(P>0.05).After treatment,the HR,RR,and MAP indicators of the two groups were significantly lower than those before treatment,and the indicators of observation group were significantly lower than those of the control group(P<0.05).After treatment,the PO;and SpO;indicators of the two groups were significantly higher than those before treatment,and the indicators of the observation group were significantly higher than those of the control group(P<0.05).Before treatment,there were no significant differences in serum CRP and ESR indicators between the two groups(P>0.05).After treatment,the serum CRP and ESR indicators in the two groups were significantly lower than those before treatment,and the indexes of the observation group were significantly lower than those of the control group(P<0.05).After treatment,the observation group’s anti-infective treatment time and length of hospitalization were significantly shorter than those of the control group(P<0.05).And the incidence of double infection in the observation group(2.32%)was significantly lower than the the control group(17.50%)(P<0.05).Conclusion:Patients with heart failure and pulmonary infection combined with positive pressure ventilation therapy and monitoring the serum procalcitonin level to guide anti-infective therapy has a definite effect,which can significantly improve the clinical symptoms and signs,inhibit the corresponding inflammatory response,and shorten the time of anti-infective treatment and lenghth of hospitalization,which can also effectively reduce the risk of double infection,so it is worthy of promotion and application.