右美托咪定治疗重症脓毒血症合并急性肺损伤和肾损伤患者的临床研究

发布时间：2018-01-02 19:30

  本文关键词：右美托咪定治疗重症脓毒血症合并急性肺损伤和肾损伤患者的临床研究　出处：《中国临床药理学杂志》2017年15期 　论文类型：期刊论文

  更多相关文章： 重症脓毒血症 急性肺损伤 右美托咪定 炎症因子 肝肾功能

【摘要】：目的观察右美托咪定对重症脓毒血症合并急性肺损伤和肾损伤患者的临床疗效、炎症因子及肝肾损伤的影响。方法将60例重症脓毒血症合并急性肺损伤和肾损伤患者随机分为对照组30例和试验组30例。2组患者均维持常规治疗。对照组使用丙泊酚注射液进行早期镇静治疗;试验组给予右美托咪定注射液1μg·kg~(-1)·h~(-1)进行早期镇静治疗。2组患者治疗时间均为48 h。记录2组患者机械通气时间、重症监护病房(ICU)入住时间及肾替代治疗(CRRT)持续时间。检测2组治疗前后的血清炎症因子水平及肝肾功能指标。结果对照组的ICU入住时间和CRRT持续时间分别为(96.32±13.51),(61.30±9.85)h;试验组分别为(76.18±11.32),(52.93±9.21)h(P0.01)。治疗后,试验组和对照组的降钙素原分别为(2.05±0.39),(2.43±0.24)ng·L~(-1);C-反应蛋白分别为(56.36±9.94),(79.91±12.55)ng·L~(-1);白细胞介素-6分别为(78.72±11.33),(92.07±12.55)ng·L~(-1);肿瘤坏死因子-α分别为(17.56±4.07),(24.41±4.25)ng·L~(-1),差异均有统计学意义(均P0.01)。治疗后,试验组和对照组的谷丙转氨酶分别为(21.37±4.73),(30.46±6.44)U·L~(-1);谷草转氨酶分别为(29.61±6.97),(38.60±7.53)g·L~(-1);碱性磷酸分别为(67.27±7.26),(71.75±8.41)U·L~(-1);总胆红素分别为(11.36±2.91),(14.72±2.29)μmol·L~(-1);尿素氮分别为(7.03±2.03),(10.07±3.12)mmol·L~(-1);血清肌酸酐分别为(87.98±10.56),(123.73±11.74)μmol·L~(-1),差异均有统计学意义(均P0.05)。2组患者治疗过程中均未出现明显的药物不良反应。结论与丙泊酚相比,右美托咪定对症脓毒血症合并急性肺损伤和肾损伤患者有更好的临床疗效,对脏器的保护作用及炎症因子的改善作用更强。
[Abstract]:Objective To observe the clinical effect of dexmedetomidine combined with acute lung injury and acute kidney injury in patients with severe sepsis, inflammatory factors and liver injury. Methods 60 cases of severe sepsis complicated with acute lung injury and renal injury patients were randomly divided into control group of 30 cases and 30 cases of test group patients in group.2 were maintained in conventional treatment the control group using Propofol Injection early sedative treatment; the experimental group was given dexmedetomidine injection 1 g - kg~ (-1) - h~ (-1) for early.2 sedation groups of patients treated for 48 h. records of 2 patients with mechanical ventilation and ICU stay time (ICU) and renal replacement the duration of treatment (CRRT). The serum levels of inflammatory factors and liver function indexes before and after treatment in 2 groups. The control group of ICU in time and duration of CRRT were (96.32 + 13.51), (61.30 + 9.85) H; experimental group respectively. 涓，

本文编号：1370638