气管插管联合血必净对急性呼吸窘迫综合征患者的效果及对患者QOL评分的影响

Effect of Tracheal Intubation Combined with Xuebijing on Patients with Acute Respiratory Distress Syndromes and Its Influence on QOL Score

目的:探讨气管插管联合血必净对急性呼吸窘迫综合征(ARDS)患者的效果及对患者生存质量(QOL)评分的影响。方法:选入2017年7月—2018年8月我院收治的100例ARDS患者,按随机数字表法分为对照组和观察组,各50例,对照组行气管插管,观察组行气管插管联合血必净(50 mL加入100 mL浓度为0.9%的氯化钠注射液中,静脉滴注,tid)治疗,比较两组治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压(PaCO2)、动脉血氧饱和度(SaO2)、动脉血氧分压/吸入气氧浓度(PaO2/FiO2),血小板计数(PLT)、纤维蛋白原(FIB)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT),白细胞介素(IL)-6、IL-8、肿瘤坏死因子(TNF)-α水平及QOL评分。结果:治疗后,观察组PaO2、PaCO2、SaO2及PaO2/FiO2低于对照组,差异有统计学意义(P<0.05);观察组PLT高于对照组,FIB、PT及APTT低于对照组,差异有统计学意义(P<0.05);观察组治疗第3 d、第7 d的IL-6、IL-8、TNF-α皆低于对照组,差异有统计学意义(P<0.05);观察组治疗后QOL评分高于对照组,差异有统计学意义(P<0.05)。结论:气管插管联合血必净治疗ARDS的疗效确切,可有效改善患者的呼吸功能与凝血异常,并有效减轻患者炎症反应,提高患者的生存质量。

Objective:To investigate the effect of tracheal intubation combined with xuebijing on patients with acute respiratory distress syndromes(ARDS)and its influence on quality of life(QOL)scores.Methods:100 patients with ARDS admitted to our hospital from July 2017 to August 2018 were selected and randomly divided into a control group and an observation group,50 cases each.The patients in the control group received tracheal intubation,and the patients in the observation group received tracheal intubation combined with xuebijing(50 mL drug was added to 100 mL 0.9%sodium chloride injection,intravenous drip,tid)treatment.The levels of arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation(SaO2),the ratio of arterial partial pressure of oxygen to inhaled oxygen concentration(PaO2/FiO2),platelet count(PLT),fibrinogen(FIB),prothrombin time(PT),activated partial prothrombin time(APTT),interleukin(IL)-6,IL-8 and tumor necrosis factor(TNF)-α,and QOL score were compared between the two groups.Results:After treatment,the levels of PaO2,PaCO2,SaO2 and PaO2/FiO2 in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The level of PLT in the observation group was higher than that in the control group,while the levels of FIB,PT and APTT were lower than those in the control group,with statistically significant differences(P<0.05).The levels of IL-6,IL-8 and TNF-αon the 3 rd and 7 th day in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The QOL score in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Tracheal intubation combined with xuebijing is effective in the treatment of ARDS,which can effectively improve the respiratory function and coagulation abnormalities of the patients,effectively reduce the inflammatory response of the patients and improve their quality of life.