摘要
目的分析乌司他丁辅助小潮气量和肺复张手法治疗中重度急性呼吸窘迫综合征(ARDS)的临床效果。方法选取2015年1月-2018年7月收治的74例中重度ARDS患者作为研究对象,根据治疗方法分为对照组和观察组,每组37例。对照组给予小潮气量和肺复张手法治疗,观察组给予乌司他丁辅助小潮气量和肺复张手法治疗。比较2组的临床效果,治疗前后血气分析指标和炎性指标,治疗后急性生理学与慢性健康状况Ⅱ(APACHEⅡ)评分、机械通气时间、住院时间以及不良反应发生情况。结果观察组治愈率高于对照组(P<0.05)。治疗后,观察组氧分压、氧合指数水平均高于对照组,二氧化碳分压水平低于对照组(P<0.05)。治疗后,观察组白介素-6、C反应蛋白和肿瘤坏死因子-α水平均低于对照组(P<0.05)。观察组APACHEⅡ评分低于对照组,机械通气时间、住院时间短于对照组(P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论乌司他丁辅助小潮气量和肺复张手法治疗可有效改善中重度ARDS患者血气分析指标和炎性反应,提高治疗效果,促进患者健康恢复。
Objective To analyze clinical effect of Ulinastatin-assisted low tidal volume and lung recruitment maneuver in treatment of patients with moderate-severe acute respiratory distress syndrome(ARDS).Methods A total of 74 patients with moderate-severe ARDS admitted during January 2015 and July 2018 were divided into control group and observation group according to therapeutic methods(n=37 in each group).Control group was treated with low tidal volume and lung recruitment maneuver,while observation group was treated with Ulinastatin-assisted low tidal volume and lung recruitment maneuver.Clinical effect,blood gas analysis indexes and inflammatory indexes before and after treatment,acute physiology and chronic health evaluationⅡ(APACHEⅡ)score after treatment,time of mechanical ventilation,hospital stay and incidence rate of adverse reactions were compared between two groups.Results Cure rate in observation group was significantly higher than that in control group(P<0.05).After treatment in observation group,levels of partial pressure of oxygen and oxygenation index were significantly higher,while level of arterial partial pressure of carbon dioxide was significantly lower than those in control group(P<0.05).After treatment,levels of interleukin-6,C-reactive protein and tumor necrosis factor-αin observation group were significantly lower than those in control group(P<0.05).In observation group,APACHEⅡscore was significantly lower,while mechanical ventilation time and hospital stay were significantly shorter than those in control group(P<0.05).There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05).Conclusion Ulinastatin-assisted low tidal volume and lung recruitment maneuver may effectively improve blood gas analysis indexes and inflammatory reaction,enhance therapeutic effects and promote recovery of patients with moderate-severe ARDS.
作者
蔡世文
王国平
史金科
滕琰
CAI Shi-wen;WANG Guo-ping;SHI Jin-ke;TENG Yan(Department of Critical Care Medicine,Chang'an Hospital of Xi'an,Xi'an 710016,China;Emergency Department,the Third Hospital of Xi'an,Xi'an 710018,China;Department of Critical Care Medicine,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)
出处
《解放军医药杂志》
CAS
2019年第9期31-34,共4页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
陕西省科学技术研究发展计划项目(2014K12-17)
关键词
乌司他丁
小潮气量
肺复张手法
呼吸窘迫综合征
成人
Ulinastatin
Low tidal volume
Lung recruitment maneuver
Respiratory distress syndrome,adult
