无创呼吸机联合抗生素降阶梯治疗急诊重症肺炎合并呼吸衰竭患者对呼吸功能的影响  

The Impact of Non-invasive Ventilator Combined with Antibiotic Step-down Therapy on Respiratory Function in Emergency Severe Pneumonia Patients with Respiratory Failure

作　　者：王利伟[1] 宋向奎[1] 万真真 Wang Liwei;Song Xiangkui;Wan Zhenzhen(Emergency Comprehensive Ward of Zhengzhou First People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第一人民医院急诊综合病区,河南郑州450000

出　　处：《哈尔滨医药》2025年第2期1-3,共3页Harbin Medical Journal

基　　金：河南省联合共建项目(20210791)。

摘　　要：目的观察呼吸机联合抗生素降阶梯治疗急诊重症肺炎合并呼吸衰竭患者的临床治疗价值。方法选取80例确诊为急诊重症肺炎合并呼吸衰竭的患者,按照随机数字表法将患者分为对照组和研究组,各40例。对照组给予抗生素降阶梯,研究组在对照组基础上行无创呼吸机,分析两组患者呼吸功能[动态肺顺应性(Dynamic lung compliance;Cdyn)、呼吸功能(Work of breathing;WOB)、氧合指数(Oxygenation index;PaO_(2)/FiO_(2))]、心律、呼吸频率、心功能[左心室舒张末期直径(Left ventricular end-diastolic diameter;LVEDD),左室射血分数(Left ventricular ejection fraction;LVEF)]、炎性因子[C反应蛋白(C-reactive protein;CRP)、肿瘤坏死因子(Tumor necrosis factor;TNF-α)]、总不良反应率以及总有效率。结果两组患者治疗后,Cdyn、WOB、PaO_(2)/FiO_(2)以及LVEF高于治疗前(P<0.05);心率、呼吸频率、LVEDD、CRP以及TNF-α低于治疗前(P<0.05);研究组总不良反应率较低,总有效率较高(P<0.05)。结论给予急诊重症肺炎合并呼吸衰竭患者无创呼吸机联合抗生素降阶梯治疗能够有效改善患者的呼吸功能,且总有效率较高,值得临床推广。Objective To observe the clinical therapeutic value of using a ventilator combined with antibiotics to lower the ladder in the treatment of emergency severe pneumonia patients with respiratory failure.Method 80 patients diagnosed with emergency severe pneumonia complicated with respiratory failure were selected.The patients were randomLy divided into a control group and a study group,with 40 patients in each group,using a random number table method.The control group was given antibiotics to reduce the risk of respiratory failure,while the study group received non-invasive ventilators on top of the control group.The respiratory function of both groups of patients was analyzed,including dynamic lung compliance(Cdyn),work of breathing(WOB),oxygenation index(PaO_(2)/FiO_(2)),heart rhythm,respiratory rate,and cardiac function,including left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),inflammatory factors such as C-reactive protein(CRP),tumor necrosis factor(tumor necrosis factor).Necrosis factor(TNF-α),total adverse reaction rate,and overall efficacy rate.Result After treatment,Cdyn,WOB,PaO_(2)/FiO_(2),and LVEF in both groups of patients were higher than before treatment(P<0.05);Heart rate,respiratory rate,LVEDD,CRP,and TNF-αwere lower than before treatment(P<0.05);The total adverse reaction rate of the research group was relatively low,and the total effective rate was relatively high(P<0.05).Conclusion The combination of non-invasive ventilator and antibiotic ladder descent can effectively improve the respiratory function of emergency severe pneumonia patients with respiratory failure,and the overall effective rate is high,which is worthy of clinical promotion.

关 键 词：无创呼吸机 抗生素降阶梯 急诊重症肺炎合并呼吸衰竭 呼吸功能 

分 类 号：R563.8[医药卫生—呼吸系统]