CAJ | 학술논문

目的：探讨合理行液体监测管理在保护重症肺炎患者中的应用价值。方法收集2012年1月~2013年1月因各种原因来四川省雅安市人民医院住院的重症肺部感染患者120例。将其随机分为研究组和对照组。入院后患者积极处理胸部外伤及腹腔等原发病，对照组给予机械通气、抗感染、解痉平喘、强心、扩管等常规干预方法，研究组在常规干预方法治疗的基础上，调整合适的液体输注，并行积极的液体监测管理。患者治疗1周后，测定肺组织局部白介素(IL)-6浓度、氧分压(PaO2)及肺泡-动脉氧分压差[P(A-a)O2]，并行胸部螺旋CT检查，比较两组效果。结果治疗前两组患者IL-6、PaO2、P(A-a)O2比较，差异无统计学意义(P>0.05)。经治疗，研究组PaO2升高较为明显，IL-6、P(A-a)O2降低，与治疗前及对照组治疗后比较，差异均有统计学意义(P<0.05)。两组不良进展、无变化、好转、明显好转、痊愈患者例数比较，差异均有统计学意义(P<0.05)。结论积极的液体管理可保护重症肺部感染患者的心肺功能，意义重大。
목적：탐토합리행액체감측관리재보호중증폐염환자중적응용개치。방법수집2012년1월~2013년1월인각충원인래사천성아안시인민의원주원적중증폐부감염환자120례。장기수궤분위연구조화대조조。입원후환자적겁처리흉부외상급복강등원발병，대조조급여궤계통기、항감염、해경평천、강심、확관등상규간예방법，연구조재상규간예방법치료적기출상，조정합괄적액체수주，병행적겁적액체감측관리。환자치료1주후，측정폐조직국부백개소(IL)-6농도、양분압(PaO2)급폐포-동맥양분압차[P(A-a)O2]，병행흉부라선CT검사，비교량조효과。결과치료전량조환자IL-6、PaO2、P(A-a)O2비교，차이무통계학의의(P>0.05)。경치료，연구조PaO2승고교위명현，IL-6、P(A-a)O2강저，여치료전급대조조치료후비교，차이균유통계학의의(P<0.05)。량조불량진전、무변화、호전、명현호전、전유환자례수비교，차이균유통계학의의(P<0.05)。결론적겁적액체관리가보호중증폐부감염환자적심폐공능，의의중대。
Objective To study the application value of reasonable line liquid monitoring and management in the pro-tection of patients with severe pneumonia. Methods 120 cases of severe pulmonary infection patients in Ya'an People's Hospital were collected from January 2012 to January 2013 dueing to various reasons to Ya'an People's Hospital, which were randomly divided into research group and the control group. After admission in patients with active treatment of chest trauma and abdominal cavity, for the primary disease, the control group were given conventional intervention methods, such as mechanical ventilation, anti-infection, spasmolysis and asthma, cardiac, expansion tube. on the basis of routine intervention treatment, research group were adjusted the appropriate fluid infusion, parallel positive fluid monitoring management. After 1 week treatment, local concentration of interleukin IL-6, lung tissue oxygen partial pressure (PaO2) and alveolar-arterial oxygen partial pressure difference [P (A-b) O2], parallel spiral CT examination in the chest were detected. The results were compared between the two groups. Results Comparison of IL-6, PaO2, P (A-b) O2 in two groups of patients before treatment, there was no statistically significant difference (P>0.05). After treat-ment PaO2 in the research group were higher relatively obvious, IL-6, P (A-b) O2 reduced, compared with before treat-ment and the control group after the treatment, the difference had statistical significance (P<0.05). Comparison of the two groups for bad progress, no change, improve, improved significantly, heal patients cases, the differences had statis-tical significance (P<0.05). Conclusion Positive fluid management can protect the heart and lung function in patients with severe pulmonary infection, which is of great significance.