摘要
目的探讨靶器官保护策略对急性肺损伤的防护作用。方法将急性肺损伤患者85例完全随机分为对照组(42例)和研究组(43例)。2组给予常规治疗,研究组为保护炎症靶器官(肠道、肺脏)加用①生大黄30g,水煎成200ml溶液(水煎15min),分2次/d口服或管饲;②静脉滴注盐酸氨溴索60mg,2次/d;③静脉注射乌司他丁40万U,1次/8h,疗程7d。监测患者治疗前后呼吸频率、PaO2、氧合指数、血清中肿瘤坏死因子-α(TNF-α)、白细胞介素6(IL-6)、IL一8水平、7d后全身炎症反应综合征(SIRS)评分及预后情况。结果2组治疗前各项监测指标差异无统计学意义,治疗后研究组患者呼吸频率、PaO,、氧合指数、SIRS评分明显优于对照组(P〈0.05);研究组TNF一仅、IL-6、IL一8于治疗第3天明显下降,改善均优于对照组(P〈0.05)。研究组7d后SIRS评分低于对照组,但差异无统计学意义[(1.7±1.3)分比(2.64-1.3)分,P〉0.05];ARDS发生率低于对照组[29.2%(12/43)比59.5%(25/42),P〈0.05];病死率虽低于对照组,但差异无统计学意义[18.6%(8/43)比25.6%(11/42),P〉0.05]。结论注重炎症靶器官保护可抑制炎症介质产生、释放和体内炎症反应的放大,提供肺保护作用。
Objective To investigate the preventive and protective effect of target organ protection strategy on acute lung injury. Methods Eighty-five acute lung injury patients were randomly divided into two groups; con- tro] group ( n = 42) was treated commonly and research group ( n = 43 ) was treated with target organ protected treatment protocols besides the conventional therapy for 7 days. Respiratory rate, oxygenation index, systemic inflammatory response syndrome (SIRS) scores, tumor necrosis factor α (TNF-α) , interleukin 6 (IL-6) and IL-8 were ana- lyzed. Results The differences between two groups were not statistically significant before treatment ( P 〉 0.05 ). The contrast of respiratory rate, oxygenation index, PaO2 and SIRS scores between two groups were statistically sig- nificant ( P 〈 0.05 ) ; the contrast of TNF-α, IL-6, IL-8 between two groups were statistically significant ( P 〈 0. 05)after treatment. The incidence of acute respiratory distress syndrome (ARDS) of experimental group reduced relatively [29.2% ( 12/43 ) vs 59.5% (25/42), P 〈 0.05 ] ; the mortality between two groups was not statistically significant [ 18.6% ( 8/43 ) vs 25.6% ( 11/42 ), P 〉 0.05 ]. Conclusions Emphasizing protecting inflammatory target organ can restrain inflammatory mediators creation and releasing, interrupt the amplification of inflammatory response and protect the pulmonary function.
出处
《中国医药》
2013年第2期162-164,共3页
China Medicine
关键词
呼吸窘迫综合征
成人
急性肺损伤
靶器官保护
肺保护
Respiratory distress syndrome, adult
Acute lung injury
Target organ protection
Lung protection