利多卡因联合艾司氯胺酮对肺部手术患者苏醒质量及术后认知功能的影响

Effects of lidocaine combined with esketamine on recovery quality and postoperative cognitive function in patients undergoing lung surgery

:-
 
目的:探讨利多卡因复合艾司氯胺酮对肺部手术患者苏醒质量及认知功能的影响。方法:选取2023年7月至2025年6月本院收治的100例拟行肺部手术患者,按随机数字表法分为观察组和对照组,各50例。对照组采用常规麻醉方案维持麻醉,观察组在常规麻醉基础上复合利多卡因及艾司氯胺酮辅助麻醉。比较两组患者苏醒质量[拔管后30min Riker镇静躁动评分(SAS)、苏醒时间、拔管时间]、认知功能[术前及术后1d、3d简易精神状态检查表评分(MMSE)]、围术期血流动力学指标[麻醉药物输注前(T0)、气管插管时(T1)、拔管后5min(T2)平均动脉压(MAP)、心率(HR)]及术后72h不良反应发生率。结果:观察组拔管后30min SAS评分、术后1d、3d的MMSE评分高于对照组,苏醒时间、拔管时间低于对照组;观察组T0、T1、T2各时间点MAP、HR无显著差异(P>0.05);对照组T1、T2时MAP、HR高于T0(P<0.05);两组不良反应发生率无显著差异(P>0.05)。结论:利多卡因复合艾司氯胺酮应用于肺部手术,可提升患者苏醒质量、保护术后认知功能,维持围术期血流动力学稳定,且安全性良好。
Objective : To investigate the effect of lidocaine combined with esketamine on recovery quality and cognitive function in patients undergoing lung surgery. Methods : A total of 100 patients receiving pulmonary resection at our hospital between July 2023 and December 2025 were enrolled and randomized via a random number table into two equal arms (n=50 per group): observation and control. The control group was treated with routine anesthesia to maintain anesthesia, and the observation group was treated with lidocaine and esketamine on the basis of routine anesthesia. The recovery quality [ Riker sedation agitation score ( SAS ) at 30 min after extubation, recovery time, extubation time ], cognitive function [ simple mental state examination score ( MMSE ) before operation and 1 d, 3 d after operation ], perioperative hemodynamic indexes [ mean arterial pressure ( MAP ), heart rate ( HR ) before anesthesia drug infusion ( T0 ), tracheal intubation ( T1 ), 5 min after extubation ( T2 ) ] and the incidence of adverse reactions at 72 h after operation were compared between the two groups. Results : In the observation group, the SAS score measured 30 minutes post-extubation and the MMSE scores at 1 day and 3 days post-operation were significantly higher than those in the control group. Conversely, both recovery and extubation times were shorter in the observation group compared to the control group. No significant differences in MAP and HR were observed at T0, T1, and T2 within the observation group (P > 0.05). In contrast, within the control group, MAP and HR at T1 and T2 were notably elevated compared to T0, with the differences being statistically significant (P < 0.05). Conclusion : The application of lidocaine combined with esketamine in lung surgery can improve the quality of recovery, protect postoperative cognitive function, maintain perioperative hemodynamic stability, and has good safety.
论著

支气管镜灌洗对儿童重症肺部感染合并肺实变的应用效果及对CT特征、肺功能影响

Application effects of bronchoalveolar lavage in children with severe pulmonary infection complicated by lung consolidation and its impact on CT features and pulmonary function

:951-956
 
目的 探讨支气管镜灌洗用于儿童重症肺部感染合并肺实变的治疗效果及对CT特征、肺功能的影响。方法 选取2022年5月—2024年5月铜仁市人民医院收治的100例重症肺部感染合并肺实变患儿开展前瞻性研究,应用随机数表法分为对照组和观察组,每组各50例。对照组患儿采取常规治疗,观察组则采取常规治疗加支气管镜灌洗治疗。对比其临床疗效,治疗前后炎症因子、CT特征及肺功能变化。结果 观察组治疗总有效率高于对照组(P<0.05);治疗后观察组患儿白细胞计数(10.36±2.52)×109/L、白细胞介素-6(20.57±5.05)ng/L、C反应蛋白(13.12±2.64)mg/L、降钙素原(101.62±12.16)pg/L均低于对照组白细胞计数(13.25±3.32)×109/L、白细胞介素-6(31.69±4.11)ng/L、C反应蛋白(16.16±4.44)mg/L、降钙素原(113.46±18.11)pg/L(P<0.05);治疗后两组患儿胸腔积液、支气管壁增厚、空气支气管征、肺部实变、磨玻璃影等相关CT影像特征占比下降,且观察组低于对照组(P<0.05);治疗后两组患儿呼气流量峰值水平均升高,观察组(90.67±18.45)L/s高于对照组(81.27±17.69)L/s,用力肺活量水平均更高,观察组(3.33±0.68)L高于对照组(2.68±0.25)L(P<0.05)。结论 针对儿童重症肺部感染合并肺实变,在常规治疗基础上增加支气管镜灌洗可提升临床疗效,减轻机体炎症反应,改善胸部CT各种表现及肺功能。
Objective To explore the therapeutic effects of bronchoalveolar lavage in children with severe pulmonary infection complicated by lung consolidation and its impact on CT features and pulmonary function.Methods A prospective study was conducted on 100 children with severe pulmonary infection complicated with pulmonary consolidation in a hospital from May 2022 to May 2024.They were randomly divided into observation group and control group using a random number table method,50 cases in each group.The control group of children received routine treatment,and the observation group received conventional treatment plus bronchoalveolar lavage.Clinical efficacy,inflammatory factors,CT features,and alterations in pulmonary function before and after therapy were compared.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,the white blood cell count(10.36±2.52)×109/L,interleukin-6(20.57±5.05)ng/L,C-reactive protein(13.12±2.64)mg/L,and procalcitonin(101.62±12.16)pg/L in the observation group were all lower than those in the control group(13.25±3.32)×109/L,interleukin-6(31.69±4.11)ng/L,C-reactive protein(16.16±4.44)mg/L,and procalcitonin(113.46±18.11)pg/L(P<0.05).After treatment,the proportion of CT imaging features such as pleural effusion,bronchial wall thickening,air bronchogram sign,lung consolidation,ground glass opacities,decreased in both groups of children,and the observation group was lower than the control group(P<0.05).After treatment,the peak levels of expiratory flow in both groups of children increased,with the observation group(90.67±18.45)L/s higher than the control group(81.27±17.69)L/s.The forced vital capacity levels were also higher,with the observation group(3.33±0.68)L higher than the control group(2.68±0.25)L(P<0.05).Conclusions Adding bronchoalveolar lavage to routine treatment for children with severe pulmonary infection complicated with pulmonary consolidation can improve their clinical efficacy,alleviate inflammatory reactions,and improve various chest CT manifestations and lung function.
论著

纤维支气管镜肺泡灌洗吸痰术联合药物治疗ICU重症肺部感染患者疗效以及炎症因子的影响

Effect of bronchofiberoptic alveolar lavage and sputum aspiration combined with medication on ICU patients with severe pulmonary infection and the influence of inflammatory factors

:1146-1151
 
目的 探讨对于重症肺部感染患者采用药物+纤维支气管镜肺泡灌洗吸痰术治疗的效果。方法 选取2021年9月—2023年5月在郑州市第一人民医院ICU中94例肺部感染患者,分为观察组、对照组,对照组进行常规治疗,观察组采用药物+纤维支气管镜肺泡灌洗吸痰术治疗,对比两组患者的疗效、症状的缓解时间、炎性因子、实验室相关指标以及不良反应。结果 治疗后,观察组患者的治疗有效率91.49%高于对照组76.60%(χ2=3.887,P<0.05),观察组患者的发热、肺部湿啰音、咳嗽以及咳痰等症状的缓解时间分别为(3.09±1.25)(4.17±2.24)(3.95±1.53)(4.05±1.77)d,均低于对照组(5.14±2.43)(7.03±3.23)(6.40±2.62)(6.32±1.81)d(t=5.143、4.988、5.536、6.147,P<0.05),观察组的 C 反应性蛋白(C-reactive protein,CRP)、白细胞介素-6(Interleukin-6,IL-6)以及Toll样受体4(Toll-like receptor 4,TLR-4)水平分别为(3.64±0.87)mg/L、(54.59±10.65)ng/mL、(7.94±1.57)%,均低于对照组(7.51±1.43)mg/L、(87.66±11.17)ng/mL、(12.11±2.48)%(t=15.850、14.690、9.740,P<0.05),观察组的气道压力、动脉血二氧化碳分压(partial pressure of carbon dioxide in artery,PaCO2)水平分别为(6.92±3.60)cmH2O、(43.19±6.29)mmHg,低于对照组(8.68±2.98)cmH2O、(55.43±5.95)mmHg,观察组动脉氧分压(Partial arterial oxygen pressure,PaO2)(86.06±5.31)mmHg、血氧饱和度(oxyhemoglobin saturation,SpO2)(98.03±6.63)%高于对照组(68.04±5.19)mmHg、(90.22±5.51)%要高(t=2.582、9.692、16.638、6.221,P<0.05),观察组中的不良反应发生率为2.13%与对照组10.64%比较差异无统计学意义(χ2=2.849,P>0.05)。结论 对处于ICU中的肺部感染患者治疗时,使用药物+纤维支气管镜肺泡灌洗吸痰术能够改善患者症状,降低炎性因子水平。
Objective To investigate the efficacy of medication combined with bronchoscopic alveolar lavage and sputum aspiration in ICU patients with severe pulmonary infection. Methods Ninety-four patients with pulmonary infection in the ICU of Zhengzhou First People's Hospital from September 2021 to May 2023 were selected and divided into observation group and control group.The control group received routine treatment,and the observation group was treated with medication and bronchoscopic alveolar lavage and sputum aspiration.The efficacy,duration of symptom remission,inflammatory factors,laboratory-related indicators and adverse reactions were compared between the two groups. Results After treatment,the effective rate of 91.49% in observation group was significantly higher than 76.60% in control group(χ2=3.887,P<0.05).The relief time of fever,pulmonary rale,cough and sputum in observation group was(3.09±1.25)d,(4.17±2.24)d,(3.95±1.53)d,and(4.05±1.77)d,respectively,which were significantly lower than the control group[(5.14±2.43)d,(7.03±3.23)d,(6.40±2.62)d and(6.32±1.81)d](t=5.143,4.988,5.536,6.147,P<0.05).The levels of CRP,IL-6 and TLR-4 in the observation group were(3.64±0.87)mg/L,(54.59±10.65)ng/mL and(7.94±1.57)%,respectively.They were significantly lower than(7.51±1.43)mg/L,(87.66±11.17)ng/mL and(12.11±2.48)% in the control group(t=15.850,14.690,9.740,P<0.05).The airway pressure and PaCO2 levels of the observation group were(6.92±3.60)cmH2O and(43.19±6.29)mmHg,respectively,which were significantly lower than those of the control group[(8.68±2.98)cmH2O and(55.43±5.95)mmHg].The levels of PaO2[(86.06±5.31)mmHg] and SpO2[(98.03±6.63)%] in the observation group were higher than those in the control group[(68.04±5.19)mmHg and(90.22±5.51)%],and there were statistically significant differences(t=2.582,9.692,16.638,6.221,P<0.05).The adverse reactions of 2.13% in the observation group were lower than 10.64% in the control group,and there was no statistically significant difference(χ2=2.849,P>0.05). Conclusions In ICU patients with severe lung infection,the treatment of drugs combined with alveolar lavage and fiberoptic bronchoscopic aspiration is better,and can significantly improve the symptoms and inflammatory factor levels of patients.
新冠病毒感染专题

肺部超声在老年新型冠状病毒肺部感染的应用价值

Application value of lung ultrasound in elderly patients with COVID-19

:21-24
 
目的 探讨肺部超声(LUS)在高龄(≥75 岁)感染新型冠状病毒肺炎(COVID-19)患者中的应用及后续对病程的监测及诊断价值。方法 回顾性分析2022年11月1日—2023年1月15日本院内科收治的25例COVID-19高龄患者进行病例归纳总结,除临床资料外,动态监测肺部超声检查情况,并与肺CT结果对比,观察检查结果,以及对病程转归的预判及影响。结果 LUS检查提示患者出现不同程度肺间质损伤,包括离散型B线(间质渗出)或融合型B线(渗入肺泡)以及肺实变(肺泡萎陷)。随着病情好转,LUS可见肺实变范围缩小,B线逐步稀疏到消散,A 线出现。结论 LUS与同期胸部CT结果一致性良好。LUS检查安全简便,重复性好,可实时动态监测,即可作为初筛手段,亦可运用于特殊人群,协助临床治疗决策。
Objective To explore the application and follow-up monitoring and diagnostic value of lung ultrasound (LUS) in elderly patients(≥75y) with novel coronavirus pneumonia (COVID-19). Methods Data of 25 COVID-19 elderly patients admitted to the Department of Internal Medicine from November 1, 2022 to January 15, 2023 were retrospectively analyzed and summarized. In addition to clinical data, dynamic monitoring of LUS was performed, and the results were compared with lung CT results. The examination results, as well as the prediction and impact on the course of disease were observed. Results LUS imaging indicated that patients had different degrees of interstitial lung injury, including discrete type B line (interstitial exudation) or fusion type B line (alveolar infiltration) and lung consolidation (alveolar collapse). With the improvement of the disease, the range of lung consolidation seen in LUS was reduced, the B-line was gradually sparse to dissipate, and the A-line appeared. Conclusions The results of LUS and chest CT in the same period are consistent. LUS examination is safe, simple, reproducible, and can be monitored dynamically in real time. It can be used as a primary screening method, and also be used in special patients to assist clinical treatment decision-making.
论著

肺部受累的惠普尔病与初治菌阴肺结核患者的临床特征对比分析

A comparative analysis of the clinical features between patients with pulmonary involvement of Whipple disease and primary treated bacteriological negative pulmonary tuberculosis

:28-33
 
目的 分析对比肺部受累的惠普尔病与初治菌阴肺结核患者的临床特征,提高对肺部受累的惠普尔病的认识、诊断及鉴别水平。方法 回顾性收集20例肺部受累的惠普尔病为病例组,并随机选取同期56例初治菌阴肺结核患者为对照组进行对比,探讨肺部受累的惠普尔病的临床特征。结果 病例组中老年(>37岁)、急性或亚急性的病程比例高于对照组(P<0.05)。CT影像学中,从病灶分布来看,病例组的病灶分布在下叶的病例比例高于对照组(P<0.05),病灶分布在上叶的病例比例低于对照组(P<0.05);从形态上看,病例组中表现为网状病灶、间质性肺炎的比例高于对照组(P<0.05),病例组中表现为空洞、纤维条索、实性影、结节影、树芽征、肺门淋巴结肿大的比例低于对照组(P<0.05),而性别、合并免疫力低下疾病、咳嗽、咳痰、发热、咳血、关节痛、腹泻等在组间比较差异均无统计学意义。病例组全部病例的肺泡灌洗液宏基因测序结果显示:惠普尔养障体是唯一菌19例(95.0%)或主要菌1例(5.00%,合并结核菌1序列),而对照组肺泡灌洗液宏基因测序结果显示:21例(37.5%)检测出结核分枝杆菌(TB)复合群是唯一菌或主要致病菌,18例TB-RNA(+),15例TB-LAMP(+)。结论 惠普尔病在临床可表现为急性或亚急性病程,好发中老年男性,以发热和(或)呼吸道症状为主,可伴或不伴有腹泻、关节痛;肺部影像学以下肺网状、间质性肺炎改变为主,可以单独累及肺部;与初治菌阴肺结核患者临床症状极其相似。应尽快完善支气管镜检查,肺泡灌洗液的宏基因检测对早期、快速诊断此病尤为重要。
Objective To analyze and compare the clinical features of patients with pulmonary involvement of Whipple disease and primary treated bacteriological negative pulmonary tuberculosis,so as to improve the recognition,diagnosis and differentiation ability of pulmonary involvement of Whipple disease.Methods Clinical features of Whipple disease with pulmonary involvement were investigated by retrospectively collecting 20 cases as a case group,comparing with 56 randomly selected patients with primary treated bacteriological negative pulmonary tuberculosis as a control group during the same period.Results The case group had a significantly higher proportion of older patients(>37 years),acute or subacute disease courses than the control group (P<0.05).On CT imaging,in terms of lesion distribution,the proportion of cases with lesions in the lower lobe was significantly more in the case group than in the control group(P<0.05),and the ratio of cases with lesions in the upper lobe was considerably less than in the control group(P<0.05).Regarding morphology,significantly more of the case group showed reticular lesions and interstitial pneumonia than the control group(P<0.05).Significantly fewer of the case group showed cavities,fibrous bands,solid shadows,nodular shadows,tree-bud signs,and enlarged hilar lymph nodes than the control group(P<0.05).No statistically significant differences existed between the two groups in gender,combined immunocompromising diseases,cough,sputum,fever,coughing up blood,arthralgia or diarrhea. At the same time,the differences of gender,combined immunocompromised disease,cough,sputum,fever,coughing up blood,arthralgia,and diarrhea were not statistically significant.The metagenomic sequencing of alveolar lavage fluid in the case group revealed Tropheryma whipplei as the sole pathogenic bacteria in 19 cases(95%)or the primary pathogenic bacteria in 1 case(5.00%,combined TB 1 sequence).In contrast,metagenomic sequencing of alveolar lavage fluid in the control group detected Mycobacterium tuberculosis complex as the sole or primary pathogenic bacteria in 21 cases(37.5%),TB-RNA(+)in 18 cases and TB-LAMP(+)in 15 cases.Conclusions Clinical presentation in Whipple disease can be of an acute or subacute course,preferably in middle-aged and older men,with fever or/and respiratory symptoms,either with or without diarrhea and arthralgia.Its pulmonary imaging dominates with reticular,interstitial pneumonia changes in the lower lungs,which can involve the lungs alone in the disease.At the same time,the clinical symptoms are highly similar to those patients with primary treated bacteriological negative pulmonary tuberculosis.Therefore,it is vital to complete bronchoscopy and metagenomic sequencing of alveolar lavage fluid as soon as possible for early and rapid diagnosis of this Whipple disease.Treatment with sensitive antibacterial drugs can result in significant improvement and save patients' lives.
论著

继发性肺结核合并肺部真菌感染的临床特点及危险因素分析

Clinical characteristics and risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection

:79-83
 
目的 探讨继发性肺结核合并肺部真菌感染的临床特点及相关高危因素。方法 收集广州市胸科医院2017年7月—2019年10月收治的继发性肺结核患者资料,病程均大于3个月,分为真菌感染组106例和非真菌感染组100例进行回顾性分析。结果 单因素分析结果显示,合并肺部其他疾病、非初治、咯血、空洞、应用广谱抗生素>l周、侵袭性操作存在统计学差异(P<0.05)。Logistic多因素分析结果显示,广谱抗生素使用>l周、侵袭性操作为真菌感染的独立危险因素(P<0.05)。结论 对于应用广谱抗生素、进行侵袭性操作的肺结核患者应警惕真菌感染风险,及早预防及诊治。
Objective To investigate the clinical characteristics and related high risk factors of secondary pulmonary tuberculosis complicated with pulmonary fungal infection. Methods Data of patients with secondary tuberculosis admitted to Guangzhou Chest Hospital from July 2017 to October 2019 were collected. All patients with a course of disease longer than 3 months were divided into the fungal infection group (n =106) and the non-fungal infection group (n =100) for retrospective analysis. Results Univariate analysis results showed that there were statistical differences in combined other pulmonary diseases, non-initial treatment, hemoptysis, cavity, application of broad-spectrum antibiotic > for 1 week, and invasive operation (P<0.05). Logistic multivariate analysis showed that >1 week of broad-spectrum antibiotics and invasive procedures were independent risk factors for fungal infection (P<0.05). Conclusion Patients with tuberculosis who are treated with broad-spectrum antibiotics and invasive procedures should be alert to the risk of fungal infection, early prevention and treatment should be undertaken.
论著

老年急性缺血性脑卒中并发肺部感染的危险因素

The risk factors of pulmonary infection in elderly patients with acute ischemic stroke

:28-31
 
目的 探讨老年急性缺血性脑卒中并发肺部感染患者的临床特征和相关危险因素。方法 采用回顾性研究方法,选择2017年7月— 2019年10月深圳市第二人民医院神经内科收治的1 113例老年急性缺血性脑卒中患者,其中卒中并发肺部感染患者(108 例)纳入感染组,未并发肺部感染患者(1 005例)纳入对照组。以单因素对比分析两组患者的临床资料,采用 Logistic多因素回归分析方法分析合并肺部感染的高危因素。结果 单因素分析提示两组年龄(尤其是高龄患者)、住院天数、房颤、脑梗死史、慢性肺疾病、吞咽困难、言语不清、意识障碍差异有统计学意义(P <0.05)。多因素 Logistics 回归分析显示,高龄(≥80岁)、住院天数、脑梗死史、吞咽困难、言语不清、意识障碍与老年急性缺血性脑卒中并发肺部感染密切相关。结论 老年急性缺血性脑卒中并发肺部感染的独立危险因素主要是高龄(≥80 岁)、住院天数、脑梗死史、吞咽困难、言语不清、意识障碍,临床应高度重视。
Objective Objective To investigate the clinical characteristics and risk factors of elderly patients with acute ischemic stroke complicated with pulmonary infection. Methods A retrospective study was conducted on 1 113 elderly patients with acute ischemic stroke admitted to the department of neurology, Shenzhen Second People's Hospital from July 2017 to October 2019. Among them, 108 patients with stroke complicated with pulmonary infection were included in the infection group and 1 005 patients without concurrent pulmonary infection were included in the control group. The clinical data of the two groups were analyzed by single factor comparison, and the risk factors for pulmonary infection were analyzed by logistic multiple factor regression analysis. Results Single factor analysis showed there were statistically significant differences between the two groups in age (especially elderly patients), length of stay in hospital, atrial fibrillation, history of cerebral infarction, chronic pulmonary disease, dysphagia, slurred speech, and disturbance of consciousness (P <0.05). Multi-factor logistic regression analysis showed that old age (≥80 years old), length of stay in hospital, history of cerebral infarction, dysphagia, slurred speech, and disturbance of consciousness were closely related to pulmonary infection in elderly patients with acute ischemic stroke. Conclusion The independent risk factors of acute ischemic stroke complicated with pulmonary infection in the elderly mainly include old age (≥80 years old), length of stay in hospital, history of cerebral infarction, dysphagia, slurred speech and disturbance of consciousness, which should be paid more attention to clinically.
临床诊疗

阿莫西林克拉维酸钾干混悬剂(7:1)联合胸腺肽治疗支气管哮喘合并肺部感染患儿的疗效

:136-138
 
目的 探讨阿莫西林克拉维酸钾干混悬剂(7:1)联合胸腺肽治疗支气管哮喘合并肺部感染患儿的临床疗效。方法 选取我院支气管哮喘合并肺部感染患儿102例,依照治疗方案不同分为研究组(n=51)、常规组(n=51)。常规组采用M胆碱受体阻断剂联合阿莫西林克拉维酸钾干混悬剂(7:1)治疗,研究组于常规组基础上采用胸腺肽治疗,统计比较两组临床疗效、随访3个月复发率及治疗前后血清炎性因子[白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平、肺功能指标[第1 s用力呼气容积(FEV1)、第1 s用力呼气容积/用力肺活量(FEV1/FVC)]。结果 研究组治疗总有效率94.12%高于常规组80.39%(P<0.05);治疗2周后研究组FEV1、FEV1/FVC水平高于常规组,血清IL-6、TNF-α水平低于常规组(P<0.05);研究组复发率3.70%(1/27)与常规组11.11%(2/18)比较,差异无统计学意义(P>0.05)。结论 阿莫西林克拉维酸钾干混悬剂(7:1)联合胸腺肽治疗支气管哮喘合并肺部感染患儿疗效显著,可降低患儿炎症反应、改善肺功能。
论著

高龄患者腹股沟嵌顿疝术后肺部感染的相关因素分析

Case-control study on correlation factors of inguinal incarcerated hernia surgery related lung infection in elderly patients

:44-48
 
目的 探讨高龄患者(≥65岁)腹股沟嵌顿疝术后肺部感染的相关因素。方法 以我院手术治疗的60例腹股沟嵌顿疝术后肺部感染的高龄患者为观察组,行1∶1匹配病例对照研究,应用单因素及多因素条件Logistic回归对相关因素进行分析,计算各因素与肺部感染的OR值及其95%可信区间。结果 研究提示术前血清白蛋白≤35 g/L(P=0.013)、术前血红蛋白≤100 g/L(P=0.029)、既往慢性阻塞性肺气肿病史(P=0.014)及抽烟(P=0.008)、手术时间≥2 h(P=0.021)、手术切除部分肠管(P=0.032)、气管插管(P=0.024)、手术季节为冬季(P=0.030)为危险因素;预防性使用抗生素(P=0.018)、术后雾化(P=0.023)、良好睡眠(P=0.048)为保护因素。结论 高龄患者腹股沟嵌顿疝术后肺部感染的发生与相关生化指标、既往史、治疗过程、环境因素等密切相关。
Objective To investigate the correlation factors of elderly patients with inguinal incarcerated hernia surgery related lung infection. Methods A hospital-based 1∶1 matched case-control study was conducted among elderly patients with inguinal incarcerated hernia surgery related lung infection,calculated the factors associated with the extent of lung infection,and the 95% confidence interval. Results The analysis showed that pre-ALB≤35g/L(P=0.013),pre-Hb≤100g/L(P=0.029),COPD(P=0.014),smoking(P=0.008),operation time(P=0.021),bowel resection(P=0.032),endotracheal intubation(P=0.024) and operation in winter(P=0.030) were the risk factors of lung infection,while the prophylactic use of antibiotics(P=0.018),aerosol inhalation(P=0.023) and good sleep(P=0.048) were the protective factors. Conclusion Some biochemical indicators,past history,therapeutic process and environmental factors were closely related to inguinal incarcerated hernia surgery related lung infection in elderly patients.
临床诊疗

莫西沙星对2型糖尿病合并肺部感染患者内皮素及降钙素基因相关肽的影响

Influence of Moxifoxacin to endothelin and calcitonin gene-related peptides in patients with type 2 diabetes mellitus combined pulmonary infection

:59-61
 
目的 探讨分析莫西沙星对2型糖尿病合并肺部感染患者内皮素及降钙素基因相关肽的影响。方法 回顾性分析2015年1月—2016年1月来我院就诊并确诊为2型糖尿病合并肺部感染的84例患者的临床资料,根据治疗方案将其分为对照组和观察组,每组各42例。对照组患者给予常规治疗,观察组患者在对照组的治疗基础上予以莫西沙星治疗。观察两组患者治疗后内皮素以及降钙素基因相关肽的变化。结果 ①观察组总有效率(92.86%)优于对照组(78.57%),两组患者间总有效率的比较有统计学意义(P<0.05);②两组患者治疗前ET、CGRP水平无差异(P>0.05)。治疗后,观察组ET水平低于对照组,CGRP水平高于对照组(P<0.05)。结论 临床应用莫西沙星治疗2型糖尿病合并肺部感染具有明显的临床疗效,值得临床推广应用。
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