本文關(guān)鍵詞：質(zhì)子泵抑制劑對危重監(jiān)護病房醫(yī)院獲得性肺炎發(fā)展及預(yù)后的影響　出處：《重慶醫(yī)科大學》2014年碩士論文　論文類型：學位論文

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【摘要】：目的探討質(zhì)子泵抑制劑（Proton pump inhibitors，PPI）對危重監(jiān)護病房（Intensive care unit, ICU）內(nèi)醫(yī)院獲得性肺炎（Hospital-acquiredpneumonia，HAP）患者感染發(fā)展和預(yù)后的影響。 方法回顧性調(diào)查某教學醫(yī)院2011年1—12月入住ICU，并存在誤吸危險因素的HAP患者臨床信息，根據(jù)是否使用PPI分組，對照分析兩組肺炎進展和預(yù)后情況，并分析PPI劑量對肺炎的影響。 結(jié)果符合入選條件者共65例，PPI組患者45例，對照組為20例�；�調(diào)查2組基礎(chǔ)疾病和各項感染指標，均無統(tǒng)計學差異。經(jīng)過1周綜合治療后，PPI組與對照組患者相比，，體溫（40%）、白細胞計數(shù)（62.2%）、氧合指數(shù)（75.6%）、動脈血氣pH值（51.1%）及A-aDO2異常者（77.8%）較多；影像學上可觀察到PPI組更易出現(xiàn)感染灶增多情況（51.1%）；更易合并血流感染（40.0%）；評估抗感染治療效果PPI組較差，28d死亡率較高（37.8%），差異具有統(tǒng)計學意義（P＜0.05）。PPI劑量對HAP感染加重與否無明顯影響（P＞0.05）。結(jié)論使用PPI的HAP患者抗感染治療效果較未使用者差，且預(yù)后欠佳，在HAP的治療中，需慎重應(yīng)用PPI。不同的PPI劑量，對肺炎發(fā)展影響不明顯。
[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.

【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R563.1

【參考文獻】

相關(guān)期刊論文 前1條

1 代芊,鄧宏,黃漢朝,王曉輝,張紅艷;GM-PFGE在院內(nèi)肺炎逆行感染途徑研究中的應(yīng)用[J];中國公共衛(wèi)生;2000年03期

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