摘要
目的探讨乌司他汀联合高氧高渗液对创伤性失血肺损伤患者肺功能的影响及预后情况。方法选取凉山州第一人民医院自2014年12月至2016年12月收治的98例创伤性失血后肺损伤患者为研究对象,采用随机数字表法分为A组(n=49)与B组(n=49)。在常规治疗的基础上,A组患者采用高氧高渗液治疗,B组患者采用乌司他汀联合高氧高渗液治疗。采用IRMA干式血气分析仪测定患者氧合指数(Pa O2/Fi O2)、血氧分压(Pa O2),并计算呼吸指数(RI)。检查患者的肺功能,记录患者的最大呼气中段流量(MMEF)、第1秒用力呼气容积(FEV1)、呼气流量峰值(PEF)及最大肺活量(FVC)等肺功能指标,并评价患者的治疗效果。结果治疗后,两组患者Pa O2/Fi O2、Pa O2及RI均较本组治疗前有所改善,差异有统计学意义(P<0.05)。B组患者Pa O2/Fi O2、Pa O2及RI均明显优于A组,两组间比较,差异均有统计学意义(P<0.05)。治疗后,两组患者的肺功能指标均较本组治疗前有所改善,且B组的MMEF、FEV1、PEF及FVC明显优于A组,两组间比较,差异有统计学意义(P<0.05)。B组患者治疗的有效率为81.6%(40/49),明显高于A组的有效率67.4%(33/49),两组间比较,差异无统计学意义(P>0.05)。结论采用乌司他汀联合高氧高渗液治疗创伤性失血肺损伤患者,不仅能有效降低患者的炎症因子,还可以改善肺功能指数,提高治疗效率。
Objective To investigate the effect of ulinastatin combined with hyperoxic hyperosmotic fluid on the pulmonary function and prognosis of patients with traumatic hemorrhagic lung injury.Methods A retrospective study was performed on 98 cases of patients with lung injury after traumatic hemorrhage who were admitted from December 2014 to December 2016.Patients were randomly divided into Group A(n=49)and Group B(n=49).On the basis of routine treatment,patients in Group A were treated with hyperoxic hyperosmotic solution,the others in Group B were treated with ulinastatin combined with hyperoxic hyperosmotic solution.The IRMA dry blood gas analyzer was used to determine the oxygenation index(PaO 2/FiO 2),blood oxygen partial pressure(PaO 2)and the respiratory index(RI)was calculated.The lung function of the patients was examined,the MMEF,FEV1 PEF and FVC lung function were recorded,and the therapeutic effect of the patients was evaluated.Results After the treatment,PaO 2/FiO 2,PaO 2 and RI were improved between the two groups(P<0.05);PaO 2/FiO 2,PaO 2 and RI in Group B were significantly better than those in Group A(P<0.05);the index of lung function were improved between the two groups,indexes of MMEF,FEV1,PEF and FVC in Group B were significantly better than those in Group A(P<0.05).The effective rate of Group B was 81.6%(40/49),which was significantly higher than 67.4%(33/49)in Group A,and there was no statistically significant difference between the two groups(P>0.05).Conclusion Ulinastatin combined with hyperoxia and hypertonic liquid in the treatment of traumatic lung injury caused by blood loss can effectively reduce the inflammatory factors,improve the pulmonary function index and improve the treatment efficiency.
作者
吴雅莉
买泓
刘瑜
WU Ya-li;MAI Hong;LIU Yu(Department of Emergency,the First People′s Hospital of Liangshan,Liangshan 615000,China)
出处
《创伤与急危重病医学》
2018年第2期86-89,共4页
Trauma and Critical Care Medicine
关键词
乌司他汀
高氧高渗液
创伤性失血
肺损伤
肺功能
预后
Ulinastatin
Hyperoxic hyperosmotic fluid
Traumatic hemorrhage
Lung injury
Lung function
Prognosis
