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Objective To explore the effect of clinical evidence management program based on evidence-based concept in the implementation of hospital bronchial pneumonia management. Methods Fifty-six patients diagnosed with bronchial pneumonia and admitted to the First Affiliated Hospital of Chongqing Medical University from January 2016 to January 2018 were enrolled. Patients were divided into study group (28 cases) and control group (28 cases). The control group was implemented routine medical management programs, including establishing cases, health education, and routine examinations; the research team was implemented the clinical pathway management scheme based on the concept of evidence-based medicine, that is, to set up a bronchopneumonia management team to manage and monitor the patient's care and treatment based on evidence-based theory, conduct regular spot checks, find problems and correct them in time, and establish a unified standardized process according to the contents specified in the clinical pathway form. The clinical efficacy, the length of hospital stay, hospitalization costs, and life quality of the patients were compared between two groups. Results The gender, age, and degree of disease of the two groups were highly balanced. Compared with the control group, the total clinical effective rate of the study group was significantly increased (92.9% vs. 71.4%, χ2= 10.746, P = 0.002), the length of hospital stay was significantly shortened (days: 9.6±1.8 vs. 13.8±2.4, t = 5.927, P = 0.001), the hospitalization costs were significantly reduced (yuan: 4 855.0±822.8 vs. 6 452.0±845.5, t = 6.210, P = 0.000). In addition, the scores of somatic pain, somatic function, physiological function, social function, vitality, psychological function, emotional function and overall health in the SF-36 scale in the study group were significantly higher than those in the control group [somatic pain: 80.71±2.23 vs. 72.87±1.77, somatic function:81.44±5.02 vs. 70.43±4.46, physiological function: 82.11±3.12 vs. 71.86±3.65, social function: 62.51±1.60 vs. 51.33±1.58, vitality: 87.40±1.65 vs. 70.11±1.90, psychological function: 82.30±1.32 vs. 75.52±1.62, emotional function: 73.66±2.81 vs. 66.54±2.60, overall health: 78.32±1.93 vs. 58.90±1.00, all P < 0.01]. Conclusion The evidence-based clinical path management program can significantly improve the clinical outcomes of patients with bronchial pneumonia, shorten the length of hospital stay, reduce hospitalization costs, and have higher patient life quality.
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This paper reviewed the content, outcome index and variations of clinical pathway of bronchopneumonia. Given the short history of such clinical pathway in China, it proves an efficient reform for curbing irrational growth of hospital expenses and reduce days of day by numerous literature. Yet further implementation and supervision are still expected.
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Objective To investigate the effect of complication and treatment compliance on PDCA nursing pathway in children with bronchial pneumonia. Methods 126 children with bronchial pneumonia were divided into two groups by random number table. There were 67 children in observation group with PDCA nursing pathway and 59 children in control group with normal nursing pathway. The effects of nursing in two groups were observed, including complications, length of hospital stay, cost, nursing compliance and satisfaction of nursing. Results The total occurrence rate of complication in observation group was 4.5%(3/67), while in control group was 18.6%(11/59). There was significant difference between the two groups (χ2=6.375, P<0.05). Compliance rate of children in observation group was 62.7%(42/67) which was significantly higher than 44.1% (26/59) of control group (χ2=4.738, P < 0.05). Hospitalization time in observation group was (5.9±2.1) d and cost was (1 703±390) yuan, while those in control group were (6.9 ± 2.8) d and (2 012 ± 501) yuan respectively. Both in observation group were obviously lower than in control group, and the difference was significant (χ2=2.161, 3.668, P<0.05). The satisfaction of nursery in observation group was significantly higher than the control group, which were 82.1% (55/67) and 61.0% (36/59) respectively. The difference was significantly different (χ2=6.944,P <0.05). Conclusions PDCA nursing pathway could decrease complication and improve treatment compliance as well as satisfaction of patients, it′s worth popularizing.
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Objective To study the clinical efficacy and safety of Yanhuning injection in the treatment of bronchial pneumonia in children.Methods 102 cases of bronchial pneumonia were randomly divided into the observation group and the control group,51 cases in each group.The control group was given conventional treatment, the observation group was given Yanhuning injection on the basis of the treatment of control group.The clinical efficacy after treatment,clinical symptoms and signs disappeared time and adverse drug reaction were compared between the two groups.Results In the observation group after treatment,the cured,improvement,invalid cases were 27 cases, 23 cases,1 case,the total effective rate was 98.04%,which in the control group were 18 cases,25 cases,8 cases,the total effective rate was 84.31%.The total effective rate of the observation group was significantly higher than that of the control group (χ2 =5.97,P 0.05).Conclusion Yan-huning injection for the treatment of children with bronchial pneumonia can significantly improve the clinical curative effect,shorten the disappearance time of the clinical symptoms and signs,the curative effect is reliable,high security.
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Objective: To evaluate the effects of Xiaoer Feire Kechuan Granule for treating children with bronchial pneumonia. Methods: A randomly controlled trial was used. One hundred and twenty children with bronchial pneumonia were studied. The children in the experimental group were given Xiaoer Feire Kechuan Granule combined with basic treatment, and in the control group only treated by basic treatment, then the children with the disease in these two groups were observed to evaluate the general curative effect, traditional Chinese medicine (TCM) syndrome efficacy, symptoms of fever, and cough disappeared time before and after treatment of TCM primary symptom integra. Results: The overall efficacies in disease, syndromes curative effect, cough effect disappeared time, primary symptom score after therapy and hospital days for children in the two groups had statistical significance (P<0.05). Conclusion: Xiaoer Feire Kechuan Granule is applicable to the treatment of infantile pneumonia by antipyretic and antitussive function, promoting the pulmonary rales absorption, and shortening the course of treatment.
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Objective To explore clinical efficacy of low molecular weight heparin combined isoproterenol inhalation in treatment of children with severe bronchial pneumonia.Methods 110 patients from Jan 2013 to Apr 2014 were collected and randomly divided into treatment group (57 cases)and control group(53 cases), control group was given anti infection,hormone, expectorant, oxygen and other symptomatic treatment, besides, inhaled with isoprenaline, bid,based on which treatment group was inhalaled with low molecular weight heparin sodium injection, qd, arterial blood gas indexes were compared between 2 groups after 72 h treatment, and clinical efficacy were compared after 5 d treatment.Results After 72 h treatment,two groups of children with pulmonary function, arterial blood gas index and airway inflammatory improved obviously;treatment group with PaO2 and PaO2/FiO2 were significantly higher than control group, while PaCO2, CRP were significantly lower than control group, the differences of all above indexes were statistically significant (P ＜ 0.05).Treatment group with wheezing, pulmonary rales, cough disappeared time were significantly lower than control group (P ＜ 0.05).After 5d treatment,treatment group with cure rate (50.9％ vs.37.7％)and total effective rate (98.2％ vs.94.3％)were both higher than control group, the differences were not statistically significant (P ＞ 0.05) .During inhalation, two groups with incidences of temporary heart rate rise (10.5 ％ vs.13.2) had no significant difference (x2 =0.189 P =0.663).Conclusion Based on conventional treatment for children with severe pneumonia,low molecular weight heparin combined with isoproterenol inhalation can improve pulmonary ventilation function,reduce airway inflammation,and improve clinical efficacy to a certain extent.
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Objective Comparison of the effects of erythromycin or azithromycin in the treatment of children bronchial pneumonia.Methods 87 cases of bronchial pneumonia were randomly divided into two groups.The observation group had 46 cases treated with azithromycin.The control group had 41 cases treated with erythromycin.The clinical curative effect and adverse reaction of two groups were compared.Results Total effective rate in the observation group(93.5％) was significantly higher than that of the control group (60.9％) (x2 =13.42,P ＜ 0.01) ; the incidence of adverse reactions in the observation group (10.9％) was significantly lower than that of the control group (60.9％) (x2 =24.09,P ＜ 0.01).Conclusion The curative effect of azithromycin is better than erythromycin on children bronchial pneumonia,and less adverse reaction.
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Objective: To investigate the effect of Tanreqing injections combined with azithromycin in the treatment of children bronchial pneumonia. Methods:Totally 56 cases of pediatric bronchial pneumonia were selected in our hospital from September 2012 to September 2013 and randomly divided into the observation group and the control group with 28 cases in each. The control group was with azithromycin treatment, and the observation group was with Tanreqing injections additionally. The effect and adverse reactions of the two groups were studied and compared. Results:In the observation group, the effective rate was 92. 9%, which was significantly higher than that in the control group(P<0. 05). The hospitalization time and the symptoms disappearance time in the observation group were significantly shorter than those in the control group (P<0. 05). The adverse reactions showed no significant difference be-tween the two groups. Conclusion:Tanreqing injections in the treatment of children bronchial pneumonia is rapid, effective and safe.
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Objective To investigate the effects of the levels of inflammatory cytokines on children with bronchial pneumonia ceftriaxone.Methods 85 cases of children with bronchial pneumonia were randomly divided into observation group (n =43) and control group (n =42).Two groups were treated on the basis of penicillin (200 000U/kg,2 times/d),the observation group ceftriaxone (20mg/kg,1 times/d) treatment on the basis of the times,7d course of treatment.The clinical efficacy of two groups were compared.The levels of C-reactive protein (CRP),interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) before and after treatment,1d,3d,5d,7d were analyzed.Results The total effective rate of observation group was 96.97％,the control group was 75.00％,the total efficiency of the two groups had significant difference (x2 =5.236,P =0.000).After treatment,fever,cough,wheezing,rales symptom score decreased significantly compared with pre-treatment,post-treatment observation group political scores were significantly lower than those of the control group,the difference was statistically significant (t =3.425,3.622,3.712,3.812,P ＜ 0.05).The levels of C RP (4.28 ± 1.07) mmol/L,IL-6 (7.21 ± 2.07) mmol/L,TNF-α(15.36 ± 3.78) mmol/L of observation group after treatment were significantly lower than those of before treatment and control groups at the same time,while the control group after treatment 5d CRP,IL-6,TNF-α levels lower than before treatment,the difference was statistically significance (P ＜ 0.05).Conclusion Ceftriaxone can effectively relieve symptoms of pneumonia in children,quickly reduce the levels of inflammatory factors,improve clinical outcomes in children.
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Objective To explore the relationship between bronchial pneumonia in children and the level of myocardial enzyme , C-reactive protein (CRP) and platelet count .Methods 1 000 cases of children with bronchial pneumonia from August 2010 to De-cember 2010 were retrospectively analyzed (bronchial pneumonia group) ,According to the clinical symptom severity ,the children wwer divided into mild bronchial pneumonia group and severe bronchial pneumonia .1 000 healthy children were recruited in control group(control group) ,and the changes of myocardial enzyme ,platelet count and CRP were tested .Results The myocardial enzyme , including aminotransferase (AST ) ,lactate dehydrogenase (LDH ) ,a- hydroxybutyric acid dehydrogenase (alpha HBDH ) ,serum creatine kinase (CK) ,CK isoenzyme (CK-MB) ,platelet count and CRP in bronchial pneumonia group were all higher than that of control group (P<0 .05);In the severe bronchial pneumonia group ,the increased rate of AST ,LDH ,α-HBDH ,CK ,CK-MB ,plate-let count and CRP indicators were significant higher than that in the mild pneumonia group (P<0 .05) .Conclusion The determina-tion of myocardial enzyme ,platelet count and CRP would be useful and helpful for the diagnosis of children bronchial pneumonia ,in particular the severe bronchial pneumonia .
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Objective To discuss the effect of moxifloxacin sequential treatment on bronchial pneumonia.Methods Patients in study group were treated by sequential treatment,and patients in control group were only intravenously dripped only with moxifloxacin.The clinical effect,changes of clinical symptoms,hospital stay time and adverse events of two groups were observed.Results The cure rate and total effective rate of study group Was significandy higher than control group(x2=8.2,P＜0.05).The clinical fever clearance time,cough disappeared time,and normal chest X-ray time of study group were significantly less than control group(t=2.309,2.617,3.134,3.157,P＜0.05).Conclusion Moxifloxacin sequential treatment of bronchial pneumonia had better effects.It had advantages to shorter hospital stay time,improve the clinical symptoms and reduce the incidence of adverse reactions.
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Objective To ohserve clinical effect of adjuvant therapy of children bronchial pneumonia with complex pulse magnetic therapeutie apparatus.Methods 65 cases with children bronchial pneumonia were randomly divided into a control group and a treatment group.Routine treatment was performed in the control group,while the treatment group was treated with complex pulse magnetic therapeutic apparatus plus routine treatmenL Compare the clinical effect and adverse reaction between the two groups.Results Clinical effect of the treatment group was obviously higher than that of the control group,showing a significant different(P＜0.05).Moreover,no adverse reaction occurred in the treatment group.Conclusion Adjuvant therapy of children bronchial pneumonia with complex pulse magnetic therapeutic apparatus demonstrated a better effect than routine treatment.It's worthy to promote application of this therapeutic method clinically.
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OBJECTIVE:To analyze the application of drugs in the treatment of pediatric bronchial pneumonia,and to provide reference for rational use of drugs in the clinic.METHODS:150 Pediatric cases of bronchial pneumonia in our hospital from Jul.2005 to Mar.2006 were randomly divided to 5 groups(n=30).Each group were given different antibacterial therpy.The hospitalization duration and medical costs were processed and analyzed using PEMS software under cured and discharge condition.RESULTS:Bactericide penicillin or cephalosporin combined with antibacterial drugs erythromycin or clindamycin would lower the antibacterial effect and aggravated economic burden of patients.Penicillin combined with cephalosporin is optimal,the cheapest and time-saving therapy for pediatric bronchial pneumonia.CONCLUSION:The application of drugs for pediatric bronchial pneumonia is reasonable basically.
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The data on 90 patients admitted to intensive care units in Bach Mai Hospital from 1999 to 2001 indicated that, 86% was infected by nosocomia bronchial tube. Gram negative organisms was highest (76%). The main bacteria were P. aeruginosa 57.3%, S. aureus 10.7%, Enterobacter 7.7%, Acinetobacter 6.8%. Almost gram negative bacteria were sensitive to Amikacin 87.8% and Imipenem 95.7%. 100% Staphylococci were not only against Penicillin, but also sensitive to co-trimoxazole 87.5% and vancomycine 75%