摘要
目的观察痰热清注射液联合纤维支气管镜对呼吸机相关性肺炎(VAP)患者呼吸力学、炎性因子及氧化应激的影响。方法将100例VAP患者随机分为观察组50例及对照组50例,对照组给予纤维支气管镜治疗,观察组在对照组治疗基础上给予痰热清注射液治疗,2组均治疗7 d。观察2组治疗前后体温、血氧饱和度[Sp(O_2)]、乳酸(Lac)、感染指数评分(CPIS)及呼吸力学、氧化应激反应、炎性因子变化情况。结果 2组治疗后体温、Lac、Sp(O_2)及CPIS评分均显著改善(P均<0.05),呼吸机呼吸力学参数气道峰压(PIP)、气道阻力(Raw)及呼吸做功(WOB)均显著降低而动脉顺应性(Cdyn)显著升高(P均<0.05),且观察组上述指标改善情况均显著优于对照组(P均<0.05);2组治疗后血清超氧化物歧化酶(SOD)、总氧化能力(TAC)及谷胱甘肽(GSH)水平均显著升高而丙二醛(MDA)水平和血清IL-1β、IL-8、TNF-α、PCT水平均显著降低(P均<0.05),且观察组上述指标改善情况均显著优于对照组(P均<0.05)。结论痰热清注射液联合纤维支气管镜能够控制改善VAP患者的肺部感染程度,改善患者呼吸功能,并有效抑制患者机体氧化应激及炎性状态。
Objective It is to observe the effects of Tanreqing injection combined with fiber bronchoscope on respiratory mechanics, inflammatory factors and oxidative stress in patients with ventilator-associated pneumonia（ VAP）. Methods 100 patients with VAP were randomly divided into observation group （ n = 50） treated with Tanreqing injection ＋ fiber bronchoscope and control group （ n = 50） treated with fiber bronchoscope, both groups were treated for 7 days. The changes of temperature, lactate （Lae） , blood oxygen saturation [ Sp（ O2 ） ] , infection index score （CPIS） and respiratory mechanics, oxidative stress response, and inflammatory factors before and after treatment were observed in both groups. Results After treatment tempera- ture, Lac, Sp（ O2 ） and CPIS scores were improved significantly （P 〈 0.05 ） , the ventilator breathing mechanics parameters such as airway peak pressure （PIP） , airway resistance （Raw） and the work of breathing （WOB） were reduced, arterial compliance （Cdyn） was increased in both groups （P 〈 0.05）; the levels of serum SOD, TAC and GSH were significantly increased while that of MDA, IL-1 beta, IL-8, TNF- alpha and PCT were decreased significantly in both groups （P 〈 0.05 ） ; the improvements of these indexes above in the observation group were better than those in the control group （ P 〈 0.05 ）. Conclusion Tanreqing injection combined with fiber bronchoscope can improve the degree of lung infection and respiratory function, and inhibit oxidative stress and inflammatory reaction in patients with VAP.
作者
李连生
李芃菲
陶素梅
靳丽丽
Lt Liansheng LI Pengfei TAO Sumei QIN Lili(The Seventh People＇ s Hospital of Hebei Province, Dingzhou 073000, Hebei, China The Fourth Hospital of Shijiazhuang, Shijiazhuang 050000, Hebei, China)
出处
《现代中西医结合杂志》
CAS
2017年第29期3208-3211,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
痰热清注射液
纤维支气管镜
呼吸机相关性肺炎
呼吸力学
氧化应激
炎性反应
Tanreqing injection
fiberoptic bronchoscope
ventilator-associated pneumonia
respiratory mechanics
oxidative stress
inflammatory reaction
