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目的探讨沙美特罗替卡松联合呼吸机辅助呼吸在重症肺炎致呼吸衰竭救治中的应用价值。方法选择2012年8月—2013年12月株洲市恺德心血管病医院收治的重症肺炎致呼吸衰竭患者80例,根据救治方法不同将患者分为对照组和观察组,各40例。对照组患者给予呼吸机辅助呼吸,观察组患者在对照组基础上给予沙美特罗替卡松雾化吸入。比较两组患者临床症状、体征缓解情况,包括氧合指数(Pa O2/Fi O2)恢复正常时间、肺部啰音缓解时间及胸片征象消失时间;治疗5 d后采集患者外周血5 ml,检测肾上腺素、去甲肾上腺素、肾素及血管紧张素Ⅱ等应激反应指标;治疗期间观察两组患者不良反应发生情况。结果观察组患者氧合指数恢复正常时间、肺部啰音缓解时间及胸片征象消失时间短于对照组,肾上腺素、去甲肾上腺素、肾素及血管紧张素Ⅱ水平低于对照组(P<0.05);两组患者均无明显不良反应发生。结论沙美特罗替卡松联合呼吸机辅助呼吸在重症肺炎致呼吸衰竭救治中具有较高的应用价值,有助于促进患者临床症状和体征的恢复、缓解应激反应,且安全性良好。
Objective To investigate the value of salmeterol / fluticasone combined with ventilator-assisted ventilation in the treatment of respiratory failure caused by severe pneumonia. Methods Eighty patients with respiratory failure caused by severe pneumonia were admitted to KaiDe Cardiovascular Hospital of Zhuzhou from August 2012 to December 2013. According to the different treatment methods, the patients were divided into control group and observation group, 40 cases in each group. Patients in the control group were given ventilator-assisted breathing. Patients in the observation group were given inhaled salmeterol-Tamsulosin on the basis of the control group. The clinical symptoms and symptom relief were compared between the two groups, including the recovery time of Pa O2 / Fi O2, the time of pulmonary auscultation and disappearance of chest X-ray signs; 5 ml of peripheral blood was collected after 5 days of treatment, Detection of adrenaline, norepinephrine, renin and angiotensin Ⅱ and other stress response indicators; observed two groups during treatment adverse reactions. Results Oxygenation index of patients in observation group returned to normal time, pulmonary auscultation time and disappearance time of chest radiograph were shorter than those in control group. The levels of epinephrine, norepinephrine, renin and angiotensin Ⅱ were lower than those in control group (P <0.05). No adverse reactions occurred in both groups. Conclusions Salmeterol / fluticasone combined with ventilator-assisted ventilation has high value in the treatment of respiratory failure caused by severe pneumonia. It is helpful to promote the recovery of clinical symptoms and signs, relieve the stress reaction and have good safety.