大剂量地塞米松联合参麦注射液治疗严重肺挫伤的疗效观察

Efficacy of high - dose dexamethasone combined with Shenmai injection in treatment of severe lung contusion

目的研究大剂量地塞米松联合参麦注射液治疗严重肺挫伤的疗效。方法选择76例严重肺挫伤的患者，随机分为对照组A组（38例）和实验组B组（38例）。A组接受常规治疗，B组在常规治疗基础上行大剂量地塞米松（20mg，静推，2次／天，连续3d）联合参麦注射液（50ml，静滴，1次／天，连续7d）治疗，两组疗程均为7d。两组患者第1、第7天均行血气分析，第1、第7天均检测血清肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）的含量。比较两组患者急性呼吸窘迫综合征（ARDS）的发生率。结果治疗前两组损伤严重度评分（ISS）、血气分析指标及血清TNF—α、IL-6、IL-8含量无统计学差异（P〉0．05），治疗后B组血气分析指标较A组明显改善（P〈0．05），血清TNF—α、IL-6、IL-8含量较A组明显下降（P〈0．05），ARDS发生率B组显著低于A组（P〈0．05）。结论大剂量地塞米松联合参麦注射液能明显抑制炎症反应，明显改善严重肺挫伤患者的肺功能。

Objective To observe the efficacy of high - dose dexamethasone combined with Shenmai injection in treatment of severe lung contusion （SLC）. Methods Seventy - six SLC patients were randomly divided into group A（ receiving routine treatment, n = 38 ）and group B（ receiving routine treat- ment plus high - dose d.examethasone and Shenmai injection, n = 38 ）. Blood gas analysis were performed and serum tumor necrosis factor alpha （ TNF -α）, interleukin 6 （ IL - 6 ） and interleukin 8 （ IL - 8 ） were measured on the 1 st and 7th day in both groups. The incidences of acute respiratory distress syndrome during treatment were compared. Results There was no statistical difference in the value of ISS or the results of blood gas analysis, serum TNF - a, iL - 6, IL - 8 in both groups before treatment （ P 〉 0.05 ）. The results of blood gas analysis in group B were improved than those in group A （ P 〈 0.05 ）. The serum TNF -α, IL - 6, IL - 8 in group B were decreased more significantly than those in group A （ P 〈 0.05 ）. The incidence of acute respiratory distress syndrome in group B was lower than that in group A（P 〈 0. 05 ）. Conclusion High- dose dexamethasone combined with Shenmai injection can significantly reduce the production of inflammatory cytokines and effectively protect the lung function in SLC patients.