血必净注射液治疗老年重症肺炎患者疗效观察(1)
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[摘要] 目的:观察血必净注射液治疗老年重症肺炎的临床效果。方法:将60例患者随机分为治疗组和对照组,均予常规治疗,治疗组加用血必净注射液。结果:治疗组平均住院天数及白细胞计数恢复正常时间明显短于对照组,T、RR、WBC、CRP等指标改善较对照组差异有显著性。结论:血必净注射液具有良好的抗炎症作用,其在老年重症肺炎的治疗中有积极的作用。
[关键词] 血必净注射液;老年重症肺炎
[中图分类号] R256.1 [文献标识码]B[文章编号]1673-7211(2008)11(c)-068-02
Therapeutic effects of Xuebijing injection on patients with elderly severe pneumonia
ZHANG Qi ,XU Ling-hua, LI Ping
(Department of Respiratory, Xuzhou Central Hospital, Xuzhou221009,China)
[Abstract] Objective: To evaluate the therapeutic effects of Xuebijing injection on patients with elderly severe pneumonia. Methods: Sixty patients were randomly divided into treatment group and control group. Two groups were both treated with antibiotics and symptomatic treatment, and additionally Xuebijing injection was given to the treatment group. Results: The average hospitalized days and the normalization time of leukocyte count were obviously shorter in the treatment group than in the control group. T, RR, WBC and CRP of the treatment group were all improved more significantly as compared to those of control group.The therapeutic efficacy was increased dramatically. Conclusion: Xuebijing injection has beneficial effects on anti-inflammatory and in the treatment of infections. Xuebijing injection has god effect in the treatment of elderly severe pneumonia.
[Key words] Xuebijing injection; Elderly severe pneumonia
重症肺炎根据获得环境不同分为重症社区获得性肺炎(SCAP)和重症医院获得性肺炎(SHAP)。SCAP及SHAP均有很高的患病率和病死率。流行病学调查显示SCAP患者的病死率可高达50%[1],而SHAP的死亡率可达70%[2]。尤其是老年患者,病情复杂,并发症多,发病急,病情进展快,免疫力低下,成为老年人死亡的常见原因。血必净注射液是以丹参、川芎、红花、当归、赤芍为主药的中药制剂,实验与临床研究显示,其在防治脓毒症和MODS方面有一定疗效[3],我们观察应用血必净注射液治疗30例老年重症肺炎患者的疗效,探讨其对老年重症肺炎的治疗价值。
1 资料与方法
1.1 一般资料
本院呼吸科收治60例老年重症肺炎患者均符合2001年美国胸科学会(ATS)制定的新定义[1]。按随机原则分为两组。治疗组30例,其中,男18例,女12例,平均年龄(74.8±10.6)岁;对照组30例中,男17例,女13例,平均年龄(72.5±12.2)岁。两组患者在性别、年龄、病程、临床症状和体征、实验室检查(炎症反应指标和血气分析)、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)方面比较,差异均无显著性(P>0.05),具有可比性。
1.2 诊断标准
主要标准:①需要机械通气;②入院48 h内病变范围扩大超过50%;③少尿(尿量<400 ml/d,或慢性肾功能衰竭患者血肌酐(SCr)>177 μmol/L(2 mg/dl)。次要标准:①呼吸频率(RR)>30次/min;②氧合指数(PaO2/FiO2)<250 mm Hg(1 mm Hg=0.133 kPa);③病变累及双肺或多肺叶;④收缩压<90 mm Hg;⑤舒张压 <60 mm Hg。符合1条主要标准或2条次要标准者,即可诊断为重症肺炎。排除既往有肿瘤、严重肝病、肺纤维化、肺结核等病史者。其中,并发糖尿病者10例,冠心病者9例 ......
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