高流量吸氧联合多黏菌素B滴注对重症肺炎患者炎症水平和血气指标的影响  

Effects of high-flow oxygen combined with polymyxin B infusion on inflammatory levels and blood gas indicators in patients with severe pneumonia

作　　者：李俊梅 米丹丽 李建英 刘燕 宋秉睿 LI Junmei;MI Danli;LI Jianying;LIU Yan;SONG Bingrui(Department of Critical Care Medicine,Zhangjiakou First Hospital,Zhangjiakou Hebei 075000,China)

机构地区：[1]张家口市第一医院内科重症医学科,河北张家口075000

出　　处：《中国急救复苏与灾害医学杂志》2024年第10期1336-1339,1344,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省卫生健康委科研基金项目(编号:20221895)。

摘　　要：目的评估高流量吸氧联合多黏菌素B滴注对重症肺炎患者炎症水平和血气指标的影响。方法样本为张家口市第一医院于2020年1月—2023年1月接收的重症肺炎患者,共102例。采用随机数字表法将患者分为两组,各51例。对照组患者接受经鼻高流量吸氧治疗,观察组在对照组的基础上联合多黏菌素B滴注,记录患者的细菌清除率、临床疗效和症状消退时间(体温恢复时间、气促消失时间、咳嗽消失时间),对比两组治疗前和治疗1周后的炎性因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)]、血气指标[动脉血氧饱和度(SaO_(2))、血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、生命体征(心率、呼吸频率)、肺功能。结果观察组的细菌清除率和临床疗效均比对照组提高,且症状消退时间更短;观察组患者治疗1周后的炎症水平、PaCO_(2)、心率和呼吸频率低于对照组,SaO_(2)、PaO_(2)和肺功能指标高于对照组,差异均有统计学意义(P<0.05)。结论高流量吸氧联合多黏菌素B滴注有助于降低重症肺炎患者的炎症水平,提高肺功能。Objective To evaluate the impact of high-flow oxygen combined with polymyxin B infusion on inflammatory levels and blood gas indicators in patients with severe pneumonia.Methods A total of 102 patients with severe pneumonia,admitted to our hospital from January 2020 to January 2023 were randomly divided into two groups,51 patients in each group.The control group received high-flow nasal oxygen therapy,while the observation group received additional polymyxin B infusion.Bacterial clearance rates,clinical efficacy,and symptom resolution times(body temperature recovery time,shortness of breath disappearance time,cough disappearance time)were recorded.Inflammatory factors(C-reactive protein[CRP],interleukin-6[IL-6],procalcitonin[PCT])and blood gas indicators(arterial oxygen saturation[SaO_(2)],arterial oxygen partial pressure[PaO_(2)],arterial carbon dioxide partial pressure[PaCO_(2)]),vital signs(heart rate,respiratory rate),and lung function were compared before treatment and one week after treatment between the two groups.Results The observation group showed higher bacterial clearance rates and overall clinical efficacy compared to the control group,Additionally,symptom resolution times were shorter.One week after treatment,the observation group had lower levels of inflammatory markers,PaCO_(2),heart rate,and respiratory rate,while SaO_(2),PaO_(2),and lung function indicators were higher,with significant statistical differences(P<0.05).Conclusion High-flow oxygen combined with polymyxin B infusion contributes to reduced inflammation levels and improved lung function in patients with severe pneumonia.

关 键 词：重症肺炎 高流量吸氧 多黏菌素B 血气指标 肺功能 

分 类 号：R563.1[医药卫生—呼吸系统]