不同治疗方案下RDQ阳性且长期卧床患者的肺部感染结局的研究

摘要

目的：观察抑制胃酸分泌与胃肠促动力药物对长期卧床且RDQ阳性患者肺部感染结局的影响。方法：将长期卧床、神志清楚且RDQ阳性的患者随机分为甲组(40例)和乙组(40例)，甲组予雷贝拉唑钠肠溶片抑制胃酸分泌治疗，乙组予盐酸伊托必利片促胃肠动力治疗，4周内观察并记录两组医院获得性肺炎(HAP)发病率、重症肺部感染症状持续时间、ICU住院时间；两组患者发生 HAP时(当日)、7 d、14 d、21 d 的 CPIS与 APACHEII 评分变化并进行比较；记录28 d及1年的病死率。结果：乙组HAP发病率、重症肺部感染症状持续时间、ICU住院时间及确诊HAP后7 d、14 d、21 d的CPIS与APACHEⅡ评分均较甲组低；乙组28 d病死率显著低于甲组(P＜0.05)。结论：促胃肠动力治疗可降低HAP的发病率，减轻HAP严重程度，降低卧床患者短期病死率，但对患者的远期预后无显著影响。%Objective:To observe the influence of inhibition of gastric acid secretion and promoting gastrointestinal motility drugs in treatment of lung infection outcome in RDQ positive patients with long-term bedridden.Methods:The patients with long-term bedridden,conscious and RDQ positive were randomly divided into the group A(40 cases)and group B(40 cases),the patients in the group A were treated with inhibition of gastric acid secretion by Rabeprazole Sodium Enteric-coated Tablets,patients in the group B were treated with promoting gastrointestinal motility by Itopride Hydrochloride Tablets,Two groups of hospital acquired pneumonia(HAP),the symptoms of severe pulmonary infection and ICU length of hospital stay were observed and recorded in 4 weeks.The patients of the two groups were recorded the changed of CPIS and APACHEⅡ scores when they occurred HAP(0)and 7 days,14 days,21 days after they occurred HAP,then we made a comparison,we recorded 28 days and 1 year mortality.Results:In the group B,the incidence rate of HAP,the symptoms of severe pulmonary infection and ICU length of hospital stay were lower than those of the group A,The 28 days fatality rate in the group A was significantly lower than that in the group B(P<0.05). Conclusion:Promoting gastrointestinal motility can decrease the incidence of HAP,reduce the severity of HAP,reduce the short-term mortality of patients with long-term bedridden,but there is no significant effect on the long-term prognosis of patients.