推拿联合抗菌药物阶梯疗法在重症肺部感染患儿中的应用  

Application of massage combined with antimicrobial ladder therapy in children with severe pulmonary infection

作　　者：卢建丽 陈慧[1] 吴婷婷[1] 胡鹏[1] LU Jian-li;CHEN Hui;WU Ting-ting;HU Peng(Nantong University Affiliated Maternal and Child Health Hospital/Jiangsu Provincial Nantong Children's Hospital,Nantong 226000)

机构地区：[1]南通大学附属妇幼保健院/江苏省南通市儿童医院,江苏南通226000

出　　处：《湖北中医药大学学报》2024年第6期26-29,共4页Journal of Hubei University of Chinese Medicine

基　　金：江苏省333高层次人才培养工程项目(项目编号:(2022)3-16-670)。

摘　　要：目的观察推拿联合抗菌药物阶梯疗法在重症肺部感染患儿中的应用效果。方法将我院90例重症肺部感染患儿随机分为对照组与观察组各45例。对照组采用抗菌药物阶梯疗法治疗,观察组采用推拿联合抗菌药物阶梯疗法治疗。比较两组临床疗效;住院、ICU、抗生素使用、呼吸机使用天数;上机前、上机后24 h血氧分压(PaO_(2))、血二氧化碳分压(PaCO_(2))、氧合指数(P/F)、酸碱度(pH)、肺泡动脉氧分压(A-aDO_(2));白细胞计数(WBC)、降钙素原(PCT)、血清乳酸(Lac)、脑钠肽(BNP)水平及小儿危重病例评分法(PCIS)评分、中医症状积分;CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、自然杀伤细胞(NK)水平。结果治疗后,观察组总有效率高于对照组(<0.05);观察组住院、ICU、抗生素使用、呼吸机使用天数短于对照组(<0.05);上机后24 h两组PaO_(2)、P/F、A-aDO_(2)高于治疗前,Pa CO_(2)、pH低于上机前;观察组PaO_(2)、P/F、A-aDO_(2)高于对照组,Pa CO_(2)、pH低于对照组(<0.05);两组WBC、PCT、Lac、BNP水平低于治疗前,PCIS评分高于治疗前;观察组BC、PCT、Lac、BNP水平低于对照组,PCIS评分高于对照组(<0.05);两组中医症状积分低于治疗前;观察组中医症状积分低于对照组(<0.05);两组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK水平高于治疗前,CD8^(+)水平低于治疗前;观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK水平高于对照组,CD8^(+)水平低于对照组(<0.05)。结论推拿联合抗菌药物阶梯疗法可显著提高重症肺部感染患儿临床疗效,缩短病程,改善血气指标,抑制炎性反应,改善症状和免疫功能,防止早期心肌损伤。Objective To observe the effect of massage combined with antimicrobial ladder therapy in children with severe pulmonary infection.Methods A total of 90 severe pulmonary infection children were randomly divided into control group and observation group,with 45 cases in each group.Control group was treated with antimicrobial ladder therapy,while observation group was treated with massage on the basis of control group.The clinical efficacy,the number of days of hospitalization,ICU,antibiotic use,ventilator use,blood partial pressure of oxygen(PaO_(2)),partial pressure of blood carbon dioxide(PaCO_(2)),oxygenation index(P/F),pH,partial pressure of oxygen in alveolar arteries(A-aDO_(2)),white blood cell count(WBC),procalcitonin(PCT),serum lactate(Lac),brain natriuretic peptide(BNP)levels and Pediatric Critical Case Scoring(PCIS)scores,TCM symptom scores,CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),and Natural killer cells(NK)levels of the two groups were compared.Results After treatment,the overall effective rate of observation group was higher than that of control group(<0.05);the number of days of hospitalization,ICU,antibiotic use and ventilator use in observation group was shorter than that in control group(<0.05);at 24 h after treatment,PaO_(2),P/F,and A-aDO_(2)in both groups were higher than those before treatment,which were higher in observation group than control group,while PaCO_(2)and pH were lower in both groups than those before treatmet,which were lower in observation group than control group(<0.05);the levels of WBC,PCT,Lac and BNP in both groups were lower than those before treatment,which were lower in observation group than control group,while the PCIS scores were higher in both groups than those before treatment,which was higher in observation group than control group(<0.05);the TCM symptom scores of both groups were lower than those before treatment,which were lower in observation group than control group(<0.05);CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and NK levels in both groups were higher than those before tre

关 键 词：重症肺部感染 小儿 推拿 抗菌药物阶梯疗法 

分 类 号：R259[医药卫生—中西医结合]