摘要
目的:探讨药学监护配合双联抗感染治疗难治性支原体肺炎(refractory mycoplasma pneumonia,RMPP)的疗效及对康复进程、预后的影响。方法:回顾性选取我院2021年5月至2023年4月RMPP患儿108例作为研究对象,按治疗方法不同分为两组,对照组54例采取常规双联抗感染治疗,观察组54例在对照组基础上给予临床药师参与的药学监护。比较两组治疗效果、康复进程、成本-效果分析、不良反应发生率及治疗前后炎性因子、肺功能指标。结果:观察组总有效率94.44%(51/54)高于对照组74.07%(40/54)(P<0.05);观察组咳嗽消失时间、退热时间、肺啰音消失时间、肺部X线阴影消失时间、住院时间分别为(6.67±1.37)d、(4.25±1.12)d、(7.22±1.55)d、(10.53±2.41)d、(14.87±2.57)d,均短于对照组[(8.92±1.60)d、(5.83±1.34)d、(9.80±1.81)d、(13.76±3.06)d、(16.38±3.11)d],均差异具有统计学意义(均P<0.05)。治疗7 d、14 d后观察组血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、IL-8、转化生长因子-β1(TGF-β1)水平均低于对照组,均差异具有统计学意义(均P<0.05);治疗7 d、14 d后观察组第1秒用力呼气量占用力肺活量比值(FEV_(1)/FVC)、最大呼气中期流速(MMF)、用力呼气25%时瞬时流速(PEF25)、最大呼气流速(PEF)均高于对照组,均差异有统计学意义(均P<0.05)。观察组成本-效果比为(21.74±6.59)低于对照组的(42.21±10.24),差异具有统计学意义(P<0.05),观察组获得1个治疗单位需花费21.74元,对照组获得1个治疗单位需花费42.21元,对照组比观察组多花费5273.34元;观察组不良反应发生率5.56%低于对照组18.52%,差异具有统计学意义(P<0.05)。结论:在双联抗感染治疗基础上增加药学监护能进一步降低RMPP患者血清炎症因子水平,改善肺功能,促进病情康复,效果确切,且安全性更高,更具成本-效果优势。
Objective:To investigate the efficacy of pharmaceutical care in dual anti-infective treatmentcombined with Refractory mycoplasma pneumonia(RMPP)in the treatment of refractory mycoplasma pneumonia(RMPP)and its impact on the recovery process and prognosis.Methods:A total of 108 caseschildren patients of with RMPP children inadmitted to our hospital from May 2021 to April 2023 were retrospectively selected as the study objects and divided into two groups according to different treatment methods.The 54 casespatients in the control group received conventional dual anti-infection therapy,and the other 54 cases in the observation group received pharmaceutical care with the participation of clinical pharmacists.The therapeutic effect,rehabilitation process,cost-effectiveness analysis,incidence of adverse reactions,inflammatory factors before and after treatment,as well aspulmonary function indexes were compared between the two 2 groups.Results:The total effective rate of observation group was 94.44%(51/54),which was higher than that of the controlgroup 74.07%(40/54)(P<0.05).The disappearance time of cough,fever,lung rura,lung X-ray shadow and hospital stay in the observation group were(6.67±1.37)d,(4.25±1.12)d,(7.22±1.55)d,(10.53±2.41)d and(14.87±2.57)d,respectively,which were all shorter than those in the control group((8.92±1.60)d,(5.83±1.34)d,(9.80±1.81)d,(13.76±3.06)d,(16.38±3.11)d)(all P<0.05).After treatment for 7 days and 14 days,the serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),IL-8 and transforming growth factor-β1(TGF-β1)in the observation group were all lower than those in the control group(all P<0.05).After treatment for 7 days and 14 days,the ratio of forced expiratory volume in the first second to forced vital capacity(FEV_(1)/FVC),the maximum mid-expiratory flow rate(MMF),the instantaneous flow rate(PEF25)and the maximum expiratory flow rate(PEF)at forced expiratory 25%in the observation group were all higher than those in the con
作者
严小玲
贺汉军
张菘
YAN Xiao-ling;HE Han-jun;ZHANG Song(Department of Pharmacy,Guangyuan First People's Hospital,Guangyuan 628000,China)
出处
《中国药物应用与监测》
CAS
2023年第6期452-457,共6页
Chinese Journal of Drug Application and Monitoring
基金
2018年四川省医学会高血压疾病(施慧达)专项科研课题(3-10)。
关键词
难治性肺炎
支原体肺炎
药学监护
治疗效果
肺功能
儿童
Refractory pneumonia
Mycoplasma pneumonia
Pharmaceutical care
Therapeutic effect
Lung function
Children
