ICU特殊护理联合氧驱动雾化吸入对重症肺炎患者炎症因子的影响

Effect of ICU special care combined with oxygen driven aerosol inhalation on inflammatory factors in patients with severe pneumonia

目的探讨重症监护室(ICU)特殊护理联合氧驱动雾化吸入对重症肺炎患者炎症因子的影响。方法选择2014年8月—2016年8月衢州市人民医院ICU病房重症肺炎患者86例,采随机数字表法随机分为2组。对照组43例予常规ICU护理和常规治疗;实验组43例,在与对照组相同常规护理基础上加用ICU特殊护理联合氧驱动雾化吸入治疗。观察2组患者治疗前后血清IL-6、CRP、TNF-α等炎症因子、金属基质蛋白功能水平、VC、FVC、FEV1及FEV1/FVC和临床症状消失时间,其结果采用统计学软件SPSS 19.0进行数据分析。结果与治疗前比较,2组患者血清IL-6、CRP、TNF-α、MMP-9水平均降低(P<0.05),VC、FVC、FEV1及FEV1/FVC水平均升高(P<0.05)。与对照组比较,实验组患者治疗后血清TIMP-1、VC、FVC、FEV1及FEV1/FVC水平均高于对照组(P<0.05),血清IL-6、CRP、TNF-α、MMP-9水平和临床症状改善时间均低于对照组(P<0.05)。结论 ICU特殊护理联合氧驱动雾化吸入能有效降低重症肺炎患者血清IL-6、CRP、TNF-α等炎症因子水平,改善肺功能,降低临床症状改善时间,较常规治疗具有更好的临床疗效。

Objective To investigate the ICU special nursing combined with oxygen atomizing inhalation effects on inflammatory factors in patients with severe pneumonia. Methods Eighty-six cases of severe pneumonia patients in our hospital ICU from August,2014 to August,2016 were selected and randomly divided into 2 groups. Forty-three cases in control group were treated with conventional ICU nursing and routine treatment,and 43 cases in experimental group were treated with conventional ICU nursing combined ICU special nursing and oxygen-driven aerosol inhalation therapy. Before and after treatment,the serum IL-6,CRP,TNF-α,metal matrix protein function,VC,FVC,FEV1,FEV1/FVC,and clinical symptoms disappearing time of two groups were observed. And the results were analyzed using statistical software SPSS19. 0. Results Compared with those before treatment,serum IL-6,CRP,TNF-α,MMP-9 of two groups were significantly decreased( P < 0. 05),VC,FVC,FEV1 and FEV1/FVC levels of two groups were significantly increased( P < 0. 05).Compared with those in the control group,serum TIMP-1 VC,FVC,FEV1 and FEV1/FVC of experimental group were significantly higher than those of control group( P < 0. 05),serum IL-6,CRP,TNF-α,MMP-9 levels and improving elapse of clinical symptoms of experimental group were significantly lower than those of control group( P < 0. 05). Conclusion ICU special nursing combined with oxygen atomizing inhalation could effectively reduce the serum IL-6,CRP,TNF-αof patients with severe pneumonia,improve lung function,reduce the time to improve clinical symptoms,and has better effect than conventional treatment.