摘要
目的针对参附注射液对肺保护通气策略实施急性呼吸窘迫综合征(ARDS)患者临床疗效观察及呼吸力学影响进行分析。方法选取2022年9月至11月赣南医学院第一附属医院综合重症加强护理病房(ICU)、急诊ICU、呼吸ICU收治的40例脓毒症诱发ARDS患者作为研究对象。采用随机数字表分为对照组和观察组,每组各20例。对照组采用ARDS保护性肺保护通气策略治疗基础上加以5%葡萄糖注射液100 ml静脉滴注,观察组采用常规ARDS肺保护通气策略治疗及常规基础治疗上加用参附注射液40 ml加入5%葡萄糖注射液100 ml静脉滴注。比较两组临床疗效、ICU住院时间、机械通气时间、动脉血气血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))、肺静态顺应性(Cstat)、气道平台压(Pplat)、吸气峰压(PIP)、血管外肺水指数(EVLW)及治疗满意度。结果治疗后观察组在ICU住院时间以及机械通气时间短于对照组,差异有统计学意义(P<0.05)。治疗前,两组PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)的比较,差异无统计学意义(P>0.05)。治疗后观察组PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)高于对照组,差异有统计学意义(P<0.05)。治疗前,两组吸力学参数的比较,差异无统计学意义(P>0.05)。治疗后观察组Pplat、PIP低于对照组,Cstat高于对照组,差异有统计学意义(P<0.05)。两组治疗前血管外肺水指数EVLW的比较,差异无统计学意义(P>0.05)。治疗后观察组血管外肺水指数EVLW低于对照组,差异有统计学意义(P<0.05)。治疗后观察组总满意度高于对照组,差异有统计学意义(P<0.05)。结论ARDS患者进行临床治疗时,开展常规肺保护通气策略,结合参附注射液,可获得明显的临床疗效,对于呼吸力学产生的影响比较积极。
Objective To analyze the clinical efficacy and respiratory mechanics effects of Shenfu Injection on acute respiratory distress syndrome(ARDS)patients under the implementation of lung protective ventilation strategy.Methods A total of 40 patients with sepsis induced ARDS admitted to the comprehensive Intensive care unit(ICU),emergency ICU and respiratory ICU of the First Affiliated Hospital of Gannan Medical College from September to November 2022 were selected as the study objects.They were divided into control group and observation group by random number table method,with 20 cases in each group.The control group was treated with ARDS protective lung protective ventilation strategy and 5%glucose injection 100 ml intravenous drip;the observation group was treated with conventional ARDS lung protective ventilation strategy and conventional basic treatment with Shenfu Injection 40 ml and 5%glucose injection 100 ml intravenous drip.The clinical efficacy,length of ICU stay,mechanical ventilation time,partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide in arterial blood(PaCO_(2)),oxygenation index(PaO_(2)/FiO_(2)),static pulmonary compliance(Cstat),airway plateau pressure(Pplat),peak inspiratory pressure(PIP),extravascular pulmonary water index(EVLW)and treatment satisfaction were compared between the two groups.Results The observation group were shorter than the control group in terms of length of stay in ICU and time spent on mechanical ventilation after treatment,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in PaO_(2),PaCO_(2)and PaO_(2)/FiO_(2)between the two groups(P>0.05).After treatment,PaO_(2),PaCO_(2)and PaO_(2)/FiO_(2)in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in suction parameters between the two groups(P>0.05).After treatment,Pplat and PIP in observation group were lower than control group,and Cstat was higher than control group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in EVLW between the two groups(P>0.05).After treatment,EVLW in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).After treatment,the satisfaction of observation group was higher than that of control group,the difference was statistically significant(P<0.05).Conclusion When ARDS patients undergo clinical treatment,routine lung protection ventilation strategies combined with Shenfu Injection can achieve significant clinical efficacy and have a positive impact on respiratory mechanics.
作者
薛正彪
郭宗文
吴超瑜
钟恒泉
谢江波
XUE Zhengbiao;GUO Zongwen;WU Chaoyu;ZHONG Hengquan;XIE Jiangbo(Zone 1,Department of Intensive Care,the First Affiliated Hospital of Gannan Medical College,Jiangxi Province,Ganzhou 341000,China)
出处
《中国当代医药》
CAS
2024年第23期36-40,共5页
China Modern Medicine
基金
江西省中医药管理局科技计划项目(2023B0097)。
关键词
参附注射液
肺保护通气
临床疗效
呼吸力学
Shenfu Injection
Lung protective ventilation
Evaluation of clinical curative effect
Respiratory mechanics
