氧气驱动雾化吸入联合有创机械通气对重症肺炎并发呼吸衰竭患者痰液黏稠度、炎症指标的影响  

Effect of oxygen-driven aerosol inhalation combined with invasive mechanical ventilation on sputum viscosity and inflammatory indicators in patients with severe pneumonia complicated by respiratory failure

作　　者：熊永辉 李修平 胡晓蓉 滕文彪 Xiong Yonghui;Li Xiuping;Hu Xiaorong;Teng Wenbiao(Intensive Care Unit,Lanxi Traditional Chinese Medicine Hospital,Lanxi 321100,Zhejiang Province,China)

机构地区：[1]兰溪市中医院重症监护室,兰溪321100

出　　处：《中国基层医药》2024年第7期976-981,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省兰溪市科技计划(2021-4-133)。

摘　　要：目的分析氧气驱动雾化吸入联合有创机械通气对重症肺炎并发呼吸衰竭患者痰液黏稠度、炎症指标的影响。方法按照前瞻性研究收集2021年6月至2023年6月在兰溪市中医院治疗的重症肺炎并发呼吸衰竭患者300例, 采用随机数字表法分为对照组(150例, 常规有创机械通气治疗)、治疗组(150例, 常规有创机械通气+氧气驱动雾化吸入治疗), 比较两组治疗前后痰液黏稠度、炎症指标、血气分析指标, 记录呼吸机相关性肺炎发生情况及患者机械通气时间、重症监护病房(ICU)时间、住院时间。结果治疗组与对照组治疗后痰液黏稠度分级差异有统计学意义(Z=7.09, P<0.05);治疗组治疗后血清白细胞介素6、10水平为(8.19±0.91)μg/L、(19.26±2.17)μg/L, 均显著低于对照组的(12.01±1.34)μg/L、(32.57±3.85)μg/L(t=28.88、36.88, 均P<0.001);治疗组治疗后动脉血氧分压为(95.75±3.51)mmHg(1 mmHg=0.133 kPa), 显著高于对照组的(90.14±3.64)mmHg(t=13.58, P<0.001), 动脉血二氧化碳分压为(40.65±4.03)mmHg, 显著低于对照组的(44.81±4.12)mmHg(t=8.84, P<0.001);治疗组治疗后呼吸机相关肺炎发生率显著低于对照组(Z=14.00, P<0.001);治疗组机械通气时间、ICU时间、住院时间均显著短于对照组(t=25.82、18.23、15.28, 均P<0.001)。结论给予重症肺炎并发呼吸衰竭患者氧气驱动雾化吸入联合有创机械通气治疗可稀释痰液, 减轻患者炎症反应, 改善其血气分析指标, 降低呼吸机相关肺炎发生风险, 促进患者康复。Objective To investigate the effect of oxygen-driven nebulization inhalation combined with invasive mechanical ventilation on sputum viscosity and inflammatory indicators in patients with severe pneumonia complicated by respiratory failure.Methods A total of 300 patients with severe pneumonia complicated by respiratory failure who received treatment at Lanxi Traditional Chinese Medicine Hospital from June 2021 to June 2023 were included in this prospective study.Using the random number table method,the patients were divided into a control group(conventional invasive mechanical ventilation,n=150)and a treatment group(conventional invasive mechanical ventilation+oxygen-driven aerosol inhalation,n=150).The sputum viscosity,inflammatory indicators,and blood gas analysis indicators were compared between the two groups before and after treatment.The occurrence of ventilator-associated pneumonia,mechanical ventilation time,intensive care unit stay duration,and the length of hospital stay were recorded.Results After treatment,the sputum viscosity grade of the treatment group was significantly different from that of the control group(Z=7.09,P<0.05).The serum levels of interleukin-6 and interleukin-10 in the treatment group were significantly lower,with values of(8.19±0.91)μg/L and(19.26±2.17)μg/L,respectively,compared with(12.01±1.34)μg/L and(32.57±3.85)μg/L in the control group(t=28.88,36.88,both P<0.05).The arterial partial pressure of oxygen in the treatment group post-treatment was(95.75±3.51)mmHg(1 mmHg=0.133 kPa),which was significantly higher than(90.14±3.64)mmHg in the control group(t=13.58,P<0.001).The arterial partial pressure of carbon dioxide in the treatment group was(40.65±4.03)mmHg,which was significantly lower than(44.81±4.12)mmHg in the control group(t=8.84,P<0.001).The incidence of ventilator-associated pneumonia in the treatment group was significantly lower than that in the control group(χ²=14.00,P<0.001).The mechanical ventilation time,intensive care unit stay duration,and the length of

关 键 词：肺炎 氧吸入疗法 呼吸功能不全 呼吸 人工 雾化器和汽化器 随机对照试验 炎症 痰 血气分析 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]