摘要
目的探讨益肾活血解毒方控制高龄骨科手术患者肺部感染效果及作用机制.方法选取2016年9月至2018年5月高龄骨科手术患者112例,分为观察组和对照组,每组各56例.两组患者均选取抗菌药物控制肺部感染,观察组加用益肾活血解毒方;比较两组患者肺部感染控制率、感染率、多重耐药率和抗菌药物使用时间、住院时间及术前(T0)、术后第一疗程结束时(T1)、第二疗程结束时(T2)、1个月后随访时(T3)炎症细胞因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、T淋巴细胞亚群、P物质(SP)水平.结果两组患者术后均康复出院,手术成功率100.00%.但观察组抗菌药物使用时间及住院时间均少于对照组,差异有统计学意义(P<0.05).肺部感染控制率高于对照组、肺部感染率和多重耐药率均低于对照组,差异有统计学意义(P<0.05).T1、T2时,观察组IL-6、TNF-α、CD8^+、SP水平低于对照组,CD4^+值高于对照组,差异均有统计学意义(P<0.05).T0、T1、T2、T3时,两组患者IL-6、TNF-α、CD8^+、SP水平均呈现先升高、后下降,CD4^+(%)先下降、后升高的趋势;但除观察组CD4^+、CD8^+变化趋势差异无统计学意义(P>0.05),其余指标水平差异均有统计学意义(P<0.05).结论益肾活血解毒方具有益肾固本、活血通络解毒之效,即通过提高机体免疫能力、减轻炎症细胞因子和SP水平而能够显著控制高龄骨科手术患者肺部感染,促进其早日康复.
Objective To study the effect and mechanism of Yishen Huoxue Jiedu Prescription on lung infection in elderly patients undergoing orthopaedic surgery. Methods A total of 112 patients with orthopedic surgery in the hospital from September 2016 to May 2018 were enrolled. The patients were divided into study group and control group by single and double numbers,with 56 cases in each group. Antibiotics were used to control pulmonary infection in both groups. The study group was supplemented with Yishen Huoxue Jiedu Decoction. Pulmonary infection control rate,infection rate,multi-drug resistance rate,antibacterial drug use time,hospitalization time and preoperative(T0),end of first postoperative course(T1),and end of second course(T2)At 1 month follow-up(T3),inflammatory cytokines(interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),T lymphocyte subsets,substance P(SP)levels were observed. Results Both groups were discharged after surgery and the success rate was 100.00%. However,the time and duration of antibiotic use in the study group were lower than those in the control group,and the difference was statistically significant(P<0.05). The control rate of lung infection was higher than that of the control group,lung infection rate and multi-drug resistance rate were lower than the control group,the difference was statistically significant(P<0.05).At T1 and T2,the levels of IL-6,TNF-α,CD8^+(%)and SP in the study group were lower than those in the control group,and the CD4^+(%)value was higher than that in the control group(P<0.05).At T0,T1,T2 and T3,the levels of IL-6,TNF-α,CD8^+(%)and SP in the two groups increased first and then decreased,and CD4^+(%)decreased first and then increased. However,except for the difference of CD4^+(%)and CD8^+(%)in the study group,there was no significant difference(P>0.05),and the other indicators were statistically significant(P<0.05). Conclusion Yishen Huoxue Jiedu Decoction has the effects of tonifying kidney and strengthening the root,activating blood circulation and dredging collaterals and detoxifying collaterals,which can significantly control the lung infection of elderly orthopedic surgery patients and improve their early recovery by improving the body's immunity and reducing the levels of inflammatory cytokines and SP.
出处
《浙江临床医学》
2019年第9期1195-1197,共3页
Zhejiang Clinical Medical Journal
关键词
骨科
高龄
手术
益肾活血解毒方
肺部感染
Orthopedics
Advanced age
Surgery
Yishen Huoxue Jiedu Prescription
Pulmonary infection
