山莨菪碱联用地塞米松治疗腹部外科疾病并发多器官功能障碍综合征

Treatment of abdominal surgery complicated with multiple organ dysfunction syndrome with combination of anisodamine and dexamethasone

目的探讨山莨菪碱联用地塞米松治疗腹部外科疾病并发多器官功能障碍综合征(MODS)患者的效果。方法(1)通过多中心、前瞻性、随机对照临床研究。(2)山莨菪碱:0.33mg(kg·次),3次d;地塞米松:0.33mg(kg·次),3次d;静脉滴注或静脉推注,共3d。结果2003年至2005年7月共收治腹部外科疾病,并发多器官功能障碍综合征(MODS)患者119例:常规治疗组共38例,22例存活,16例死亡,病死率为42.11%。地塞米松组共36例,24例存活,12例死亡,病死率为33.33%。山莨菪碱联用地塞米松组共45例,34例存活,11例死亡,病死率为24.44%。以上数据,经χ2检验,P<0.01。运用联用山莨菪碱和地塞米松治疗需手术MODS患者的治疗方案,使MODS抢救成功率进一步提高,病死率降低。结论MODS及MOF病因复杂,治疗困难,病死率高,山莨菪碱联用地塞米松能遏止住患者的危重状态,为紧急手术和下一步的治疗赢得时间,从而降低了病死,并且对重要脏器无损伤作用。

Objective To investigate anisodamine combined with dexamethasone on the treatment of abdominal surgery with multiple organ dysfunction syndromes （MODS）. Methods A multi-centers, prospective and random clinical investigation was carried out. Both 0.33 mg/kg of anisodamine and dexamethasone were administrated through vein three times a day for three days. Results There were 38 patients in the control group and 16 died, with mortality 42.11%. Among the 36 patients in dexamethasone group, 12 died, with mortality 33.33%. In anisodamine and dexamethasone group, there were 11 patients died in 45 patients, with mortality 24.44%. These mortalities were compared by 2, p 〈 0.01. Conclusion Using of anisodamine and dexamethasone together could inhibit the critical and severe status of patients, make possible for emergency operation or other treatment, and decrease the mortality significantly.