痰热清联合抗生素治疗ICU内呼吸机相关性肺炎的疗效及预后观察

摘要

目的 研究痰热清注射液对呼吸机相关性肺炎(VAP)的治疗作用及对预后的影响.方法 选取诊断为VAP的患者58例,试验组30例,对照组28例.均常规应用抗生素抗感染治疗,试验组同时给予痰热清注射液.观察患者体温、白细胞计数(WBC)、中性粒细胞(NE)、C反应蛋白(CRP)、血小板压积(PCT)及胸片的变化情况.评估痰热清对VAP的治疗效果及预后.结果 治疗后7 d,试验组痊愈7例,显效10例,有效9例,无效4例,总有效率为86.7%.对照组痊愈4例,显效8例,有效10例,无效6例,总有效率为78.6%.两组总有效率比较差异有统计学意义(P<0.05).两组治疗后体温、PCT、WBC检查结果比较,差异均有统计学意义(P<0.05).观察28 d试验组机械通气时间为(5.3±2.6)d,住ICU时间为(6.5+3.6)d,抗生素使用时间为(9.3±4.6)d,28 d死亡率为9%.对照组机械通气时间为(8.5±4.1)d,住ICU时间为(9.1+4.9)d,抗生素使用时间为(13.3±6.3)d,28 d死亡率为20%.两组比较差异均有统计学意义(P<0.05).结论 痰热清注射液联合抗生素能增强VAP疗效,改善预后.%Objective To study the efficacy and prognosis of Tanreqing Injection to treat ventilator associated pneumonia (VAP). Methods 58 cases diagnosed as VAP were chosen, with 30 cases in test group and 28 cases in control group. They were both given routine therapy of antibiotics for anti-infective. And the test group was given Tanreqing Injection at the same time. The body temperature, WBC, NE, CRP, PCT and X-ray changes were observed. The treatment and prognosis of Tanreqing for VAP were assessed. Results After 7 days of treatment, for the test group: 7 cases were cured, 10 cases were excellent, 9 cases were effective, 4 cases were invalid, and the total effective rate was 86.7%. For the control group: 4 cases were cured, 8 cases were excellent, 10 cases were effective, 6 cases were invalid, and the total effective rate was 78.6%. The total effective rate between the two groups was significantly different (P ＜ 0.05). There were significant differences of the results of temperature, PCT, WBC of the two groups after treatment (P ＜ 0.05). The test group was observed in 28 days. The mechanical ventilationtrial were (5.3±2.6) days, the ICU stay were (6.5±3.6) days, the antibiotic using were (9.3±4.6) days, and the mortality rate was 9% in 28 days. For the control group, the mechanical ventilationtrial were (8.5+4.1) days, the ICU stay were (9.1 ±4.9) days, the antibiotic using were (3.3±6.3) days, and the mortality was 20% in 28 days. The prognosis index between the two groups was significantly different (P ＜ 0.05). Conclusion Tanreqing Injection combined with antibiotics can enhance the efficacy of treating VAP, and it can improve prognosis.