热毒宁注射液早期阻断中低危社区获得性肺炎向脓毒症发展的回顾性分析  

Retrospective Analysis of the Development of Sepsis from Middle and Low Risk CAP to Early Blocking by Reduning Injection

作　　者：周运航 袁思成 黄肖玲 华胜毅 芮庆林[1] Zhou Yunhang;Yuan Sicheng;Huang Xiaoling;Hua Shengyi;Rui Qinglin(The Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中国中医急症》2022年第5期801-804,811,共5页Journal of Emergency in Traditional Chinese Medicine

基　　金：江苏省中医药管理局立项项目(YB201813);江苏省中医药管理局中医重点学科项目(K2013XKO3)。

摘　　要：目的总结中低危社区获得性肺炎(CAP)院内发生脓毒症的相关因素,观察早期运用热毒宁注射液对减少脓毒症发生的影响。方法采取回顾性研究的方法,收集符合标准的中低危CAP病例资料,统计分析院内脓毒症发生情况以及影响脓毒症发生的因素,并根据住院前3 d运用热毒宁注射液≥40 mL参与治疗定义为热毒宁组,余为对照组,分析热毒宁注射液治疗对减少脓毒症发生与最终临床疗效的影响。结果共纳入研究病例1118例,其中院内发生脓毒症76例,中药治疗(OR=0.476)、肺炎严重指数(PSI)评分(OR=1.038)、低氧血症(OR=6.721)为影响中低危CAP院内发生脓毒症的因素(P<0.05);所有病例中,热毒宁组137例,对照组981例,在倾向性匹配与基线对比后,分析显示热毒宁组最终临床疗效优于对照组(P<0.05),院内发生脓毒症的比例与对照组类似,组间比较无明显统计学差异(P>0.05)。结论中低危CAP病患中,PSI评分高、低氧血症可增加院内发生脓毒症的风险,中药治疗可降低发生风险,同时热毒宁注射液早期无阻断脓毒症发生的优势,但对临床恢复有着积极的意义。Objective:To summarize the related factors of nosocomial sepsis of low and medium-risk community-acquired pneumonia(CAP),and to explore the effect of early application of Reduning Injection on reducing the occurrence of sepsis.Methods:Data of the low and medium-risk CAP cases that met with the criteria were collected and retrospectively studied.The incidence of nosocomial sepsis and the factors affecting its occurrence were statistically analyzed.Patients who received Reduning Injection≥40 m L for 3 days before hospitalization were the Reduning group,and the rest were the control group.The effect of Reduning Injection on reducing the occurrence of nosocomial sepsis and the final clinical efficacy were analyzed.Results:A total of 1118 cases were included in the study,of which 76 cases developed sepsis in hospital.Among them,traditional Chinese medicine treatment(OR=0.476),pneumonia-severity PSI score(OR=1.038),hypoxemia(OR=6.721)were the influencing factors of nosocomial sepsis in middle-and low-risk CAP patients(P<0.05);among all the cases,137 cases were in the Reduning group and 981 cases were in the control group.After comparison between propensity matching and baseline,analysis showed that the final clinical efficacy of Reduning group was better than that of the control group(P<0.05),and the proportion of nosocomial sepsis was similar to that of control group,with no significant statistical difference between groups(P>0.05).Conclusion:In patients with medium-and low-risk CAP,high PSI score and hypoxemia can increase the risk of nosocomial sepsis,and traditional Chinese medicine treatment can reduce the risk of sepsis.Meanwhile,Reduning Injection does not have the advantage of blocking the occurrence of sepsis in the early stage,but it has a positive significance for clinical recovery.

关 键 词：脓毒症 社区获得性肺炎 热毒宁注射液 肺炎严重指数 

分 类 号：R563.1[医药卫生—呼吸系统]