摘要
目的探讨血必净注射液联合抗生素治疗急诊ICU重症肺感染患者临床效果。方法前瞻性选取2018年8月至2020年8月如皋市人民医院收治的100例急诊ICU重症肺感染患者作为研究对象,随机数字表法分为2组,各50例,均行常规治疗。对照组依照患者药物敏感试验结果选择对应抗生素,研究组在此基础上联合血必净注射液。比较2组患者临床效果,治疗前和治疗15 d后C反应蛋白(CRP)、白细胞计数(WBC)、临床肺部感染评分(CPIS)、脑钠素(BNP)、Toll样受体4(TLR4)水平,机械通气时间、药物治疗时间、肺啰音消失时间和ICU住院时间以及不良反应发生率情况。结果治疗15 d后,研究组临床效果优于对照组(96.00%vs.72.00%),差异有统计学意义(P<0.05)。治疗前2组患者CRP、WBC、CPIS比较,差异无统计学意义(P>0.05),治疗15 d后研究组患者CRP[(31.01±7.90)mg/L vs.(46.73±10.18)mg/L]、WBC[(7.18±2.74)109/L vs.(10.76±3.95)109/L]、CPIS[(2.30±2.05)分vs.(4.28±2.16)分]明显低于对照组,差异有统计学意义(P<0.05)。治疗前2组患者BNP、TLR4水平比较,差异无统计学意义(P>0.05),治疗15 d后研究组患者BNP[(431.40±89.00)mg/mL vs.(824.30±156.50)mg/mL]、TLR4[(8.00±0.95)%vs.(10.25±1.05)%]水平低于对照组,差异有统计学意义(P<0.05)。研究组患者机械通气时间[(6.15±1.30)d vs.(9.30±1.40)d]、肺啰音消失时间[(6.30±1.50)d vs.(10.25±2.22)d]、药物治疗时间[(5.90±1.30)d vs.(9.65±1.55)d]和ICU住院时间[(13.20±2.50)d vs.(17.85±3.25)d]低于对照组,差异有统计学意义(P<0.05)。研究组患者不良反应发生率低于对照组(4.00%vs.16.00%),差异有统计学意义(P<0.05)。结论与单纯抗生素治疗相比,血必净注射液联合抗生素治疗急诊ICU重症肺感染患者可有效提高临床效果,降低CRP、BNP、TLR4水平,控制肺部感染,缩短临床指标改善时间,降低不良反应发生率,确保治疗效果,具有较高的临床应用价值。
Objective To investigate the effect of xuebijing injection combined with antibiotics in treatment of patients with severe pulmonary infection in emergency ICU.Methods From August 2018 to August 2020,100 patients with severe lung infection in the emergency ICU admitted to the Rugao People's Hospital were prospectively selected as the research objects.They were divided into 2 groups with 50 cases in each group by random number table,and performed received conventional treatment.The control group was treated with antibiotic treatment based on the results of the drug sensitivity test,and the study group was treated with Xuebijing injection on this basis.The effect,levels of C-reactive protein(CRP),white blood cell count(WBC),clinical lung infection score(CPIS),brain natriuretic peptide(BNP),Toll-like receptor 4(TLR4)before treatment and 15 days after treatment,mechanical ventilation time,the time of drug treatment,the disappearance time of pulmonary rales,the length of ICU hospitalization,and the incidence of adverse reactions were compared.Results The treatment effect of the study group was better than that of the control group(96.00%vs.72.00%),and the difference was statistically significant(P<0.05).There was no significant difference in CRP,WBC,CPIS between the two groups before treatment(P>0.05).After 15 days of treatment,CRP[(31.01±7.90)mg/L vs.(46.73±10.18)mg/L]of the study group,WBC[(7.18±2.74)109/L vs.(10.76±3.95)109/L],CPIS[((2.30±2.05)points vs.4.28±2.16)points]were significantly lower than those of the control group,the differences were statistical significance(P<0.05).There was no significant difference in the levels of BNP and TLR4 between the two groups before treatment(P>0.05).After 15 days of treatment,the levels of BNP[(431.40±89.00)mg/mL vs.(824.30±156.50)mg/mL],TLR4[(8.00±0.95)%vs.(10.25±1.05)%]were lower than those of the control group,the differences were statistically significant(P<0.05).Mechanical ventilation time[(6.15±1.30)d vs.(9.30±1.40)d],disappearance time of pulmonary rales[(6.30±1.50)d vs.(10.25±2.22)d],drug treatment time[(5.90±1.30)d vs.(9.65±1.55)d]and ICU length of stay[(13.20±2.50)d vs.(17.85±3.25)d]were lower than those of the control group,and the differences were statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group(4.00%vs.16.00%)and the difference was statistically significant(P<0.05).Conclusion Compared with antibiotic therapy alone,Xuebijing injection combined with antibiotics for emergency ICU patients with severe lung infection can effectively improve the clinical effect,reduce CRP,BNP and TLR-4 levels,control lung infection,shorten the improvement time of clinical indicators,and reduce the occurrence of adverse reactions rate,to ensure the treatment effect,has high clinical application value.
作者
陈兰
范青青
冯佳佳
CHEN Lan;FAN Qing-qing;FENG Jia-jia(Department of Critical Care Medicine,Rugao People's Hospital,Rugao Jiangsu 226500,China.)
出处
《临床和实验医学杂志》
2021年第4期383-387,共5页
Journal of Clinical and Experimental Medicine
基金
江苏省科技厅研究基金资助项目(编号:201207689X)。
