摘要
目的探讨早期糖皮质激素联合无创呼吸支持治疗重症肺炎的临床疗效。方法选取该院2010年4月至2013年3月收治的重症肺炎符合无创机械通气条件并采用糖皮质激素治疗的患者50例,比较患者治疗前和治疗3、24 h后的呼吸、心率、pH值、动脉血氧分压(PaO2)、动脉二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)、上机时间、生存率以及胸部X射线片。结果经糖皮质激素联合无创机械通气治疗后,患者呼吸窘迫症状缓解,PaO2、PaO2/FiO2明显改善,高碳酸血症明显纠正,患者的心率明显下降,呼吸困难明显减轻,与治疗前比较,差异有统计学意义(P<0.05);平均上机时间(5±3)d;胸部X射线片显示病灶明显吸收43例,5例因治疗效果欠佳改用气管插管行有创机械通气,3例并发多脏器功能障碍死亡。结论对重症肺炎患者早期应用糖皮质激素联合无创呼吸支持治疗,可以迅速纠正缺氧、改善临床症状和预后。
Objective To explore the clinical efficacy of early corticosteroids combined noninvasive respiratory support in the treatment of severe pneumonia. Methods 50 cases of severe pneumonia enrolled in Shifang People＇s Hospital from April 2010 to March 2013 were selected ,whose treatment were in line with the requirement of noninvasive mechanical ventilation com- bined with glueocorticords. Breathing, heart rate, pH, PaO2, PaCO2, PaOJFiO2, operating time, survival time and chest X-ray before the treatment,3 hours after treatment and 24 hours after treatment were compared. Results After treatment of glucocorticoids with noninvasive mechanical ventilation, respiratory distress was relieved;PaO2 and PaOJFiO~ were improved obviously;hyper- capnia was corrected significantly ; heart rate decreased obviously and dyspnea was reduced greatly. Comparing with the prethera- py, the difference had statistical significance （P〈O.05）. Average operating time was （5~3）d ;chest X-ray showed that focus of 43 cases were absorbed obviously, 5 cases used trachea cannula with mechanical ventilation because of poor therapeutic effect and 3 cases died of muhiplicate organ disfunction syndrome. Conclusion Early application of glucocorticoid combined noninvasive ventila- tion in treating patients with severe pneumonia can quickly correct hypoxia and improve the clinical symptoms and prognosis.
出处
《现代医药卫生》
2013年第17期2597-2598,共2页
Journal of Modern Medicine & Health
关键词
肺炎
糖皮质激素类
呼吸
人工
治疗结果
Pneumonia
Glucocorticoids
Respiration,artificial
Treatment outcome
