质子泵抑制剂对危重监护病房医院获得性肺炎发展及预后的影响

发布时间：2018-01-01 17:30

本文关键词：质子泵抑制剂对危重监护病房医院获得性肺炎发展及预后的影响　出处：《重庆医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的探讨质子泵抑制剂（Proton pump inhibitors，PPI）对危重监护病房（Intensive care unit, ICU）内医院获得性肺炎（Hospital-acquiredpneumonia，HAP）患者感染发展和预后的影响。方法回顾性调查某教学医院2011年1—12月入住ICU，并存在误吸危险因素的HAP患者临床信息，根据是否使用PPI分组，对照分析两组肺炎进展和预后情况，并分析PPI剂量对肺炎的影响。结果符合入选条件者共65例，PPI组患者45例，对照组为20例。基线调查2组基础疾病和各项感染指标，均无统计学差异。经过1周综合治疗后，PPI组与对照组患者相比，，体温（40%）、白细胞计数（62.2%）、氧合指数（75.6%）、动脉血气pH值（51.1%）及A-aDO2异常者（77.8%）较多；影像学上可观察到PPI组更易出现感染灶增多情况（51.1%）；更易合并血流感染（40.0%）；评估抗感染治疗效果PPI组较差，28d死亡率较高（37.8%），差异具有统计学意义（P＜0.05）。PPI剂量对HAP感染加重与否无明显影响（P＞0.05）。结论使用PPI的HAP患者抗感染治疗效果较未使用者差，且预后欠佳，在HAP的治疗中，需慎重应用PPI。不同的PPI剂量，对肺炎发展影响不明显。
[Abstract]:Objective to investigate the impact of Proton pump inhibitors (PPI) on the development and prognosis of hospital acquired pneumonia (Hospital-acquiredpneumonia, HAP) in the critical care unit (Intensive care unit).
Methods the clinical information of HAP patients who were admitted to ICU in a teaching hospital from 1 to December in 2011 and there were risk factors for aspiration were retrospectively investigated. According to whether the PPI group was used, the progression and prognosis of the two groups were compared and analyzed, and the influence of PPI dosage on pneumonia was analyzed.
The eligible persons were 65 cases, 45 PPI patients, 20 cases in the control group. 2 groups of basic disease and the infection index at baseline, there was no significant difference. After 1 weeks of treatment, PPI group compared with the control group, the body temperature (40%), white blood cell count (62.2%). The oxygenation index (75.6%), arterial blood gas values of pH (51.1%) and A-aDO2 (77.8%) were abnormal; imaging can be observed in the PPI group is more prone to infection increases (51.1%); more easily complicated with bloodstream infection (40%); anti infection treatment effect of group PPI is poor assessment, higher mortality (28d 37.8%), the difference was statistically significant (P < 0.05) dose of.PPI had no obvious effect to increase HAP infection or not (P > 0.05). The effect of anti infection conclusion use of PPI therapy in patients with HAP compared with non users, and the prognosis is poor, in the treatment of HAP, PPI should be cautious with different doses of PPI.. Impact on the development of pneumonia Obviously.

【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R563.1

【参考文献】