大剂量沐舒坦在上腹部手术围手术期中应用的临床研究

The Clinical Research of Large Dose Mucosolvan Applied to the Perioperative Period of the Upper Abdominal Operation

目的探讨大剂量沐舒坦在上腹部围手术期中应用的临床价值。方法 40例上腹部手术患者随机分为两组,治疗组(20例)应用大剂量沐舒坦静脉滴注(330mg/次,每天3次,连续10天);对照组(20例)按常规沐舒坦剂量(30mg/次,每天3次,连续10天)。比较两组手术前后血白细胞计数(white blood cell count,WBC)、pH值、氧分压(PaO2)、二氧化碳分压(PaCO2)、血浆二氧化碳含量(TCO2)和IL-10水平的变化,以及术后肺部情况的变化。结果手术前两组血WBC、pH值、PaO2、PaCO2、TCO2和IL-10水平均无显著性差异,术后第7天,两组血WBC与各自术前相比有统计学意义(P<0.05);术后第3天开始,治疗组PaO2和TCO2显著改善,与对照组同期相比具有统计学意义(P<0.05);术后第1、3和7天,两组的IL-10水平较术前显著升高(P<0.05),治疗组在术后第3天和第7天,IL-10升高显著高于同期对照组水平(P<0.05);而两组PaCO2手术前后未见明显变化;术后治疗组肺部情况明显改善者9例(45%),肺部感染者2例(10%);对照组肺部情况改善者2例(10%),肺部感染者8例(40%),差异有统计学意义(χ2=8.107,P<0.05)。结论大剂量沐舒坦在上腹部手术围手术期使用安全有效,值得临床推广。

Objective To investigate the clinical effect of large dose mucosolvan applied to the perioperative period of the upper ab- dominal operation. Methods 40 cases of patients undergoing the upper abdominal operation were randomly divide into two groups. The treatment group （n=20） was administered continuously intravenous drip of large-dose mucosolvan （330 mg each time, three times a day for 10 days）, and the control group was administered continuously intravenous drip of routine-dose mucosolvan （30 mg each time, three times a day for 10 days）. The level of White Blood Cell Count （WBC）, pH, PaO2, PaCO2, TCO：, and interleukin-10 （IL-10） and the incidence of pul- monary infection were analyzed in the preoperation and postoperation. Results The levels of WBC, pH, PaO2, PaCO2, TCO2, and IL-10 in both groups were not found any changes at the preoperation. The level of WBC in both groups started to significantly reduce at the 7th day of postoperation （P〈0.05）. Unlike the level of PaCO2, those of PaO2 and TCO2 in the treatment group improved better at the third days of postoperation, and were significantly superior to that of the control group （P 〈0.05）. The level oflL-10 in both groups was higer at the postoperation than that of the preoperation （P〈0.05）. Moreover, it in the treatment group was higer dramatically that of the control group at the 3rd and 7th days of postoperation （P〈0.05）. The infection of lung infection in the treatment was 10% at the postoperation, which was lower significantly than that of the control group （40%） （X2 = 8.107, P〈0.05）. Conclusion The large dose mucosolvan applied to the perioperative period of the upper abdominal operation are safe and effective, suggesting popularization in the clinic.