乌司他丁联合肺泡复张法治疗非肺源性急性呼吸窘迫综合征

发布时间：2018-04-30 02:09

本文选题：乌司他丁 + 急性呼吸窘迫综合征　；参考：《第二军医大学学报》2017年07期

【摘要】：目的探讨乌司他丁联合肺泡复张法治疗非肺源性急性呼吸窘迫综合征(ARDS)的临床疗效。方法选取我院2014年6月—2016年6月行乌司他丁联合肺泡复张法治疗的42例非肺源性ARDS患者为试验组,同期仅行肺泡复张法治疗的45例非肺源性ARDS患者为对照组。采用血气分析仪记录两组患者治疗前后的桡动脉氧分压(PaO2)、二氧化碳分压(PaCO2)和氧合指数(OI),呼吸机监测患者的吸气峰压(PIP)、气道平台压(Pplat)、肺静态顺应性(Cs)和肺动态顺应性(Cd),ELISA检测患者血清IL-6、TNF-α和IL-10的含量。结果试验组患者在治疗后第2、3、5、6、7天的桡动脉PaO2均高于对照组(P0.05),治疗后第1、3、5、7天的PaCO2高于对照组(P0.05),治疗后第6、7天的OI高于对照组(P0.05)。与治疗前相比,两组患者治疗后的PIP、Pplat均下降(P0.05),Cs、Cd均上升(P0.05);但试验组患者治疗后PIP、Pplat、Cs和Cd的改变更加明显,与对照组相比差异有统计学意义(P0.05)。与治疗前相比,对照组与试验组患者治疗后IL-6、TNF-α含量均下降(P0.05),IL-10含量增加(P0.05),试验组患者治疗后IL-6、TNF-α和IL-10含量较对照组相比差异有统计学意义(P0.05)。结论与单纯肺泡复张法治疗相比,乌司他丁联合肺泡复张法可更为有效地改善ARDS患者的肺损伤和肺通气。
[Abstract]:Objective to investigate the clinical effect of ulinastatin combined with pulmonary alveolar compound Zhang Fa in the treatment of non-pulmonary acute respiratory distress syndrome (ARDS). Methods 42 non-pulmonary ARDS patients treated with ulinastatin combined with alveolar complex Zhang Fa from June 2014 to June 2016 in our hospital were selected as experimental group, and 45 patients with non-pulmonary ARDS treated only with alveolar complex Zhang Fa as control group. Blood gas analyzer was used to record the radial arterial oxygen partial pressure (Pao _ 2), carbon dioxide partial pressure (Paco _ 2) and oxygenation index (Oi _ 2) before and after treatment. Ventilator was used to monitor the inspiratory peak pressure (PIP), airway plateau pressure (Pplata), pulmonary static compliance (CSS) and pulmonary dynamic compliance. Serum IL-6 TNF- 伪 and IL-10 were detected by Elisa. Results the PaO2 of radial artery in the trial group was higher than that in the control group on the 7th day after treatment, and the PaCO2 of the control group was higher than that of the control group on the 7th day after treatment, and the Oi of the control group was higher than that of the control group on the 6th day after treatment. Compared with before and after treatment, the levels of PIPP / Pplat in the two groups were all decreased and the levels of CsN and CD were increased after treatment, but the changes of PIPP platon Cs and CD in the trial group were more obvious than those in the control group, and the difference was statistically significant compared with that in the control group (P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%, P 0. 05%). Compared with before treatment, the contents of IL-6 TNF- 伪 in the control group and the experimental group were all decreased after treatment. The content of IL-10 in the patients in the test group was increased after treatment. The levels of TNF- 伪 and IL-10 in the patients in the test group were significantly higher than those in the control group (P 0.05). Conclusion ulinastatin combined with pulmonary alveolus and Zhang Fa can improve lung injury and ventilation more effectively in patients with ARDS than that in patients with ARDS treated with Zhang Fa alone.
【作者单位】：第二军医大学东方肝胆外科医院麻醉与危重病科;
【基金】：国家自然科学基金(81270756)~~
【分类号】：R563.8

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