卡托普利和硝苯地平治疗急性肺损伤合并高血压患者的疗效观察

发布时间：2018-06-01 16:54

  本文选题：创伤后急性肺损伤 + 急性呼吸窘迫综合征　； 参考：《中华高血压杂志》2017年03期

【摘要】：目的观察卡托普利和硝苯地平治疗重症胸外伤致急性肺损伤(ALI)合并高血压患者的血压控制情况。方法 2010年1月至2015年12月,入选沈阳医学院附属中心医院胸外重症监护病房严重创伤致ALI,且合并2级以上高血压患者105例;分为卡托普利组(常规治疗基础上+卡托普利片12.5~50.0mg/次,3次/d,口服或鼻饲,n=51)和硝苯地平组(常规治疗基础上+硝苯地平缓释片10~20mg/次,3次/d,口服或鼻饲,n=54)。两组均治疗7d。观察两组患者的呼吸频率、氧分压、急性生理与慢性健康评分(APACHEⅡ)、创伤严重程度评分(ISS)、机械通气时间、住重症监护病房时间、急性呼吸窘迫综合征(ARDS)的发生率和病死率。结果治疗7d后,卡托普利组呼吸频率[(15.3±5.4)比(22.4±5.4)次/min]、氧分压[(78.3±12.2)比(61.5±12.6)mm Hg]、机械通气时间[(85.4±25.4)比(114.5±22.5)h]、住重症监护病房时间[(5.4±3.1)比(9.5±4.4)d]均优于硝苯地平组,ARDS发生率(37.2%比57.4%)和病死率均(0%比14.8%)低于硝苯地平组(P0.05);而两组血压控制总有效率差异无统计学意义。结论在治疗重症胸外伤致创伤后ALI伴高血压的患者中,控制高血压满意且无差异的前提下,卡托普利较硝苯地平更利于ALI的治疗。
[Abstract]:Objective to observe the blood pressure control of captopril and nifedipine in the treatment of acute lung injury caused by severe thoracic trauma (ALI) with hypertension. Methods from January 2010 to December 2015, 105 patients with grade 2 hypertension were enrolled in the severe trauma induced by severe trauma in the extrathoracic intensive care unit of the affiliated Central Hospital of Shenyang Medical College. They were divided into two groups: captopril group (12.5~50.0mg/ 3 / d, oral or nasal feeding) and nifedipine group (nifedipine sustained release tablet 10~20mg/ 3 times / d, oral or nasal feeding). Both groups were treated for 7 days. The respiratory frequency, partial pressure of oxygen, acute physiological and chronic health score (Apache 鈪，

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