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目的综合评价农村地区糖尿病患者接种23价肺炎疫苗和流感疫苗预防肺炎及呼吸道感染的效果及意义。方法在管理的糖尿病患者中,采用自愿报名的方式,确定126例研究对象。将研究对象中不愿意接种23价肺炎疫苗和流感疫苗的66例患者作为对照组,自愿联合接种23价肺炎疫苗和流感疫苗的60例患者作为干预组,比较两组患者在随访1年内的肺炎发病率、呼吸道感染发病率、抗生素使用率及住院率等。结果干预组接种23价肺炎疫苗后接种部位出现不良反应12例(20.0%);接种流感疫苗后接种部位出现不良反应6例(10.0%),患者不良反应症状均在48h内自行缓解。干预组1年内肺炎发生率为0,明显低于对照组的7.6%,差异具有统计学意义(P<0.05)。干预组1年内呼吸道感染发生率为43.3%,明显低于对照组的71.2%,差异具有统计学意义(P<0.05)。干预组1年内呼吸道感染患者抗生素使用率为53.8%,明显低于对照组的76.6%,差异具有统计学意义(P<0.05)。干预组1年内住院率为7.7%,低于对照组的17.0%,但差异无统计学意义(P>0.05)。结论在糖尿病患者中接种23价肺炎球菌多糖疫苗和流感疫苗,接种后不良反应率低,能减少患者发生肺炎、呼吸道感染和住院的次数,还可以降低呼吸道感染的抗生素使用率,且接种安全性高,值得在农村地区的糖尿病患者中推广应用。
Objective To comprehensively evaluate the effect and significance of prevention and treatment of pneumonia and respiratory tract infection by 23-valent pneumonia vaccine and influenza vaccine in diabetic patients in rural areas. Methods In the management of diabetic patients, using voluntary registration method to determine the 126 subjects. Sixty-six patients who were not willing to inoculate 23-valent pneumococcal vaccine and influenza vaccine were selected as control group and 60 patients who volunteered with 23-valent pneumonia vaccine and influenza vaccine as intervention group. The pneumonia was compared between two groups within one year of follow-up Incidence, incidence of respiratory infections, antibiotic use and hospitalization rates. Results There were 12 cases (20.0%) of the adverse reactions in the inoculation site after inoculation of the 23-valent pneumonia vaccine in the intervention group. Six cases (10.0%) of the adverse reactions occurred in the inoculation site after inoculation of the influenza vaccine. The symptoms of patients were relieved within 48 hours. The incidence of pneumonia was 0 in the intervention group within one year, which was significantly lower than that in the control group (7.6%), the difference was statistically significant (P <0.05). The incidence of respiratory infection in the intervention group was 43.3% in one year, which was significantly lower than that in the control group (71.2%) (P <0.05). In the intervention group, the antibiotic use rate in patients with respiratory tract infection in one year was 53.8%, which was significantly lower than that in the control group (76.6%). The difference was statistically significant (P <0.05). The hospitalization rate in the intervention group was 7.7% within 1 year, which was lower than that in the control group (17.0%), but the difference was not statistically significant (P> 0.05). Conclusion Inoculation of 23-valent pneumococcal polysaccharide vaccine and influenza vaccine in patients with diabetes can reduce the incidence of pneumonia, respiratory infections and hospitalizations, reduce the incidence of adverse reactions, reduce the use of antibiotics in respiratory infections, and vaccination safety High, it is worth to promote the application of diabetes in rural areas.