脂微球-前列腺素E1治疗急性呼吸窘迫综合征的临床观察

发布时间：2018-10-18 11:08

【摘要】：目的观察分别接受脂微球前列腺素E1(lipo-PGE1)和常规治疗的急性呼吸窘迫综合征(ARDS)患者的动脉血气指标、氧合状况的变化,评价其治疗效果。方法对2005年1月~2010年12月该院收治的79急性呼吸窘迫综合征病人进行回顾性分析。其中,41例采用静脉应用lipo-PGE1治疗,38例进行常规治疗,lipo-PGE1治疗组在入院24 h后静脉滴注lipo-PGE1 3 ng/(kg·min),持续2 h,每天2次,连用1~2周。记录两组治疗前后生物学标记物,并在各个指标均衡可比的基础上,应用t检验比较两组患者的血流动力学、动脉血气、呼吸机通气时间、住ICU时间,生存率比较采用χ2检验。结果 lipo-PGE1治疗组和常规治疗组生存率差别具有显著性(P0.05),呼吸机通气时间、患者住ICU 1时间差别也均有显著性(均P0.05)。lipo-PGE1治疗组氧分压、氧合指数(氧分压/吸氧分数)恢复比常规治疗组早(P0.05)。lipo-PGE1还能有效降低肺血管阻力和肺动脉压,增加心排量和氧输送量。结论 lipo-PGE1治疗ARDS有疗效明确,能缩短住ICU时间,降低患者病死率和医疗费用。
[Abstract]:Objective to observe the changes of arterial blood gas index and oxygenation in patients with acute respiratory distress syndrome (ARDS) treated with lipid microspheres prostaglandin E1 (lipo-PGE1) and routine therapy, and to evaluate the therapeutic effect. Methods 79 patients with acute respiratory distress syndrome admitted in our hospital from January 2005 to December 2010 were retrospectively analyzed. Among them, 41 cases were treated by intravenous lipo-PGE1 and 38 cases by routine therapy. In the lipo-PGE1 group, lipo-PGE1 3 ng/ (kg min), was infused intravenously for 2 h, twice a day for 2 h, and used continuously for 1 minute and 2 weeks after admission 24 hours after admission. The biological markers were recorded before and after treatment, and on the basis of balanced and comparable indexes, the hemodynamics, arterial blood gas, ventilator ventilation time, ICU residence time and survival rate of the two groups were compared with t test by 蠂 2 test. Results there were significant differences in survival rate between lipo-PGE1 treatment group and routine treatment group (P0.05). The time of ventilator ventilation and the duration of ICU 1 residence in lipo-PGE1 group were also significantly different (P0.05). Oxygenation index (oxygen partial pressure / oxygen fraction) recovered earlier than routine treatment group (P0.05). Lipo-PGE1 can also effectively reduce pulmonary vascular resistance and pulmonary artery pressure increase cardiac output and oxygen delivery. Conclusion lipo-PGE1 is effective in the treatment of ARDS. It can shorten the duration of ICU and reduce the mortality and medical cost.
【作者单位】：深圳市急救中心;
【分类号】：R563.8

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