摘要
目的 分析高压氧治疗联合异丙托溴铵雾化吸入在老年重症肺炎(SP)合并呼吸衰竭(RF)患者中的应用效果。方法 选取连云港市第一人民医院2020年5月—2023年8月收治的97例老年SP合并RF患者,按不同治疗方法将其分为2组,对照组47例采取异丙托溴铵雾化吸入,观察组50例另加用高压氧治疗,均治疗4周,对比两组治疗效果。结果 观察组显效、有效患者分别有29例、19例;对照组显效、有效患者分别有26例、11例。两组治疗有效率有统计学差异(χ^(2)=6.670,P=0.010)。治疗后,观察组血气指标水平、动态顺应性(Cdyn)、呼吸做功(WOB)、吸气阻力(RAW)、C反应蛋白(CRP)、降钙素原(PCT)、可溶性髓系细胞触发受体-1(STREM-1)优于对照组(P<0.05)。治疗后,观察组肺炎严重指数(PSI)、急性生理与慢性健康状况(APACHEⅡ)评分低于对照组(P<0.05)。观察组与对照组不良反应发生率对比无统计学差异(χ^(2)=2.460,P=0.117)。对两组患者随访1年,观察组病死率4.00%(2/50)低于对照组19.15%(9/47)(Log-rankχ^(2)=4.458,P=0.035)。结论 高压氧联合异丙托溴铵雾化吸入治疗可有效改善老年SP合并RF患者血气指标,提升呼吸功能,病死率和不良反应发生率较低。
Objective To analyze the effect of hyperbaric oxygen therapy combined with atomized inhalation of ipratropium bromide in elderly patients with severe pneumonia(SP)complicated with respiratory failure(RF).Methods 97 elderly patients with SP combined with RF were selected from the First People´s Hospital of Lianyungang City from May 2020 to August 2023,and divided into 2 groups according to different treatment methods.47 patients in the control group received atomized inhalation of ipratropium bromide,and 50 patients in the observation group were treated with hyperbaric oxygen for a total of 4 weeks,and the therapeutic effects of the two groups were compared.Results In the observation group,there were 29 obvious and 19 effective patients,respectively.In the control group,there were 26 obvious and 11 effective patients,respectively.The effective rate was compared between the two groups(χ^(2)=6.670,P=0.010).After treatment,blood gas index levels,dynamic compliance(Cdyn),respiratory work done(WOB),inspiratory resistance(RAW),C-reactive protein(CRP),procalcitonin(PCT)and soluble myeloid cell trigger receptor-1(STREM-1)in observation group were better than those in control group(P<0.05).After treatment,the pneumonia severity index(PSI),acute physiological and chronic health status(APACHEⅡ)score in the observation group were lower than those in the control group(P<0.05).The occurrence of adverse reactions was compared between the experimental group and the control group(χ^(2)=2.460,P=0.117).After 1-year follow-up,the fatality rate of observation group was 4.00%(2/50)lower than that of control group[19.15%(9/47)(Log-rankχ^(2)=4.458,P=0.035)].Conclusion Hyperbaric oxygen combined with ipratropium bromide atomized inhalation therapy can effectively improve blood gas indexes in elderly SP patients with RF,improve respiratory function,and lower mortality and adverse reactions.
作者
吴伟
徐瑞
丁胜
WU Wei;XU Rui;DING Sheng(Department of Emergency Medicine,the First People's Hospital of Lianyungang City,Lianyungang Jiangsu 222000,China)
出处
《中国急救复苏与灾害医学杂志》
2025年第8期1071-1074,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
江苏省卫健委老年课题面上项目(LKM2022064)。
关键词
重症肺炎
呼吸衰竭
高压氧
异丙托溴铵
雾化吸入
Severe pneumonia
Respiratory failure
Hyperbaric oxygen
Ipratropium bromide
Atomizing inhalation
