摘要
目的探索铜绿假单胞菌肺炎患者14 d内转重症的风险因素,分析中药干预的效果,为临床改进治疗方案提供依据。方法收集2016年1月至2021年2月于天津中医药大学第一附属医院住院的铜绿假单胞菌肺炎患者的临床资料,根据其14 d的内预后分为转重症组和非转重症组,用Cox回归分析转重症的相关风险因素及中药干预效果。结果共纳入患者197例,转重症患者37例,中药干预率为67.01%。Cox多因素回归分析示慢性心功能不全[HR=2.045,95%CI(1.050,3.983)]、胃管置入[HR=3.474,95%CI(1.225,9.851)]、痰热壅肺证[HR=2.005,95%CI(1.045,3.846)]是铜绿假单胞菌肺炎患者转为重症的独立风险因素,中药干预[HR=0.500,95%CI(0.260,0.963)]是患者转重症的保护因素。结论慢性心功能不全、胃管置入、痰热壅肺证是铜绿假单胞菌肺炎转重症的风险因素,使用中药可预防患者转为重症肺炎,特别对痰浊阻肺证患者疗效显著。
Objective:To explore the risk factors for severe cases of pseudomonas aeruginosa pneumonia in pa⁃tients within 14 days,analyze the effectiveness of traditional Chinese medicine intervention,and provide a basis for clinical improvement of treatment plans.Methods:Clinical data of patients with pseudomonas aeruginosa pneumo⁃nia admitted to the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from January 2016 to February 2021 were collected.They were divided into two groups based on their 14 day prognosis:the conversion to severe group and the non-conversion to severe group.Cox regression analysis was used to analyze the relevant risk factors for conversion to severe disease and the effectiveness of traditional Chinese medicine inter⁃vention.Results:A total of 197 patients were included,including 37 patients who became critically ill.The inter⁃vention rate of traditional Chinese medicine was 67.01%.Cox multivariate regression analysis showed that chronic heart failure[HR=2.045,95%CI(1.050,3.983)],gastric tube insertion[HR=3.474,95%CI(1.225,9.851)],and phlegm heat obstruction in the lung[HR=2.005,95%CI(1.045,3.846)]were independent risk factors for patients with pseudomonas aeruginosa pneumonia to become critically ill;traditional Chinese medicine intervention[HR=0.500,95%CI(0.260,0.963)]was a protective factor for patients turning severe.Conclusion:Chronic heart fail⁃ure,gastric tube insertion,and phlegm heat obstruction in the lung syndrome are risk factors for the conversion of pseudomonas aeruginosa pneumonia to severe pneumonia.The use of traditional Chinese medicine can prevent pa⁃tients from turning into severe pneumonia,especially for patients with syndrome of turbid phlegm obstructing lung.
作者
王睦天
赵启亮
张慧琪
孙宏源
刘奉云
陈明虎
刘旻
Wang Mutian;Zhao Qiliang;Zhang Huiqi;Sun Hongyuan;Liu Fengyun;Chen Minghu;Liu Min(The Frist Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China)
出处
《中国中医急症》
2023年第12期2078-2081,共4页
Journal of Emergency in Traditional Chinese Medicine
基金
天津市中医药重点领域科研项目(2021010)
天津中医药大学第一附属医院学科发展基金(XKJJ201734)
天津中医药大学第一附属医院2018年度“拓新工程”(201909)。
关键词
重症肺炎
铜绿假单胞菌
中医
风险因素
Severe pneumonia
Pseudomonas aeruginosa
Traditional Chinese medicine
Risk factor
