| 摘要: |
| [摘要]目的：分析ε-聚赖氨酸对儿科机械通气患儿管路细菌定植、呼吸机相关性肺炎（VAP）发生情况及肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）表达水平的影响。方法：回顾性分析杭州市萧山区中医院2017年8月至2019年8月收治的60例机械通气患儿的临床资料，按照是否给予ε-聚赖氨酸干预分为观察组和对照组各30例，观察组给予ε-聚赖氨酸干预，对照组不做处理，观察并记录两组管路不同位置的细菌定植情况、VAP发生情况、机械通气时间、TNF-α及IL-6表达水平，然后进行对比分析。结果：上机第4天和第7天，对照组Y型接口处（66.67%、77.67%）及进气段（33.33%、66.67%）、出气段冷凝水部位（46.67%、80.00%）细菌阳性检出率均高于观察组（均为0%）（P<0.05）；观察组VAP发生率（10.00%）低于对照组（40.00%），机械通气时间（4.36±0.55）d，短于对照组（7.31±0.49）d（P<0.05）；观察组患儿上呼吸机后第4天和第7天的TNF-α（39.25±11.88、18.56±4.65）ng/mL及IL-6（29.38±8.33、20.05±9.48）pg/mL表达水平低于对照组（P<0.05）。结论：ε-聚赖氨酸干预法能够抑制儿科机械通气管路的细菌定植，降低VAP发生率，缩短机械通气时间,降低TNF-α及IL-6等免疫炎性反应因子。 |
| 关键词: 呼吸机相关性肺炎 儿科 机械通气 ε-聚赖氨酸干预法 管路细菌定植 血清炎症因子 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2021.10.004 |
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| 基金项目: |
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| Effects of ε-Polylysine on Bacterial Colonization, Ventilator-Associated Pneumonia and Expression Levels of TNF-α and IL-6 in Children with Mechanical Ventilation |
| Dai Mina1, Hu Peng2, Zhang Liqin2 |
| (1. Zhejiang Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine, Zhejiang Hangzhou 311201, China; 2. Jiangsu Nantong Maternal and Child Health Hospital, Jiangsu Nantong 226000, China) |
| Abstract: |
| [Abstract] Objective: To analyze the effects of ε-polylysine on bacterial colonization, ventilator-associated pneumonia (VAP) and expression levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in children with mechanical ventilation. Methods: Clinical data of 60 children with mechanical ventilation admitted into Hangzhou Xiaoshan Hospital of Traditional Chinese Medicine from Aug. 2017 to Aug. 2019 were retrospectively analyzed. According tor ε-polylysine intervention, all patients were divided into the observation group and the control group, with 30 cases in each group. The observation group was given ε-polylysine intervention, while the control group was left untreated. The bacterial colonization, occurrence of VAP, time of mechanical ventilation, expression levels of TNF-α and IL-6 at different positions of pipelines in two groups were observed, recorded and compared. Results: On the 4th and 7th d after ventilator, the positive bacterial detection rate in the control group at the Y-type junction (66.67% and 77.67%), inlet section (33.33% and 66.67%) and condensate section (46.67% and 80.00%) was higher than that in the observation group (0% and 0%), the difference was statistically significant (P<0.05). The incidence of VAP in the observation group (10.00%) was lower than that in the control group (40.00%), and the time of mechanical ventilation in the observation group (4.36±0.55) d was shorter than that in the control group (7.31±0.49) d (P<0.05). The expression levels of TNF-α (39.25±11.88, 18.56±4.65) ng/mL and IL-6 (29.38±8.33, 20.05±9.48) pg/mL in the observation group were lower than those in the control group on the 4th and 7th d after ventilator (P<0.05). Conclusion: The ε-polylysine method can inhibit bacterial colonization of pediatric mechanical ventilation, reduce the incidence of VAP, shorten the time of mechanical ventilation, and decrease the levels of inflammatory factors such as TNF-α and IL-6. |
| Key words: ventilator-associated pneumonia pediatrics mechanical ventilation ε-polylysine intervention bacterial colonization serum inflammatory factors |
