短程大剂量地塞米松辅助治疗对重度烧伤合并急性呼吸窘迫综合征心肺功能的影响

Short- range High- dose Dexamethasone Adjuvant Therapy for Severe Burns Complicated by Acute Respiratory Distress Syndrome Cardiopulmonary Function

目的探讨短程大剂量地塞米松辅助治疗对重度烧伤合并急性呼吸窘迫综合征(ARDS)心肺功能的影响。方法将40例重度烧伤合并ARDS患者随机分成观察组与对照组,每组20例,两组均给予补液、机械通气、气管切开、抗感染及营养支持等对症治疗,两组均联合地塞米松治疗,观察组每隔4 h静脉滴注1次,每次80 mg,持续1 d;对照组每隔8 h静脉滴注1次,每次40 mg,持续3 d。比较两组患者心肺功能的变化。结果观察组用力肺活量(FVC)、1秒钟用力呼气容积(FEV1)和FEV1/FVC均较对照组有明显改善(P<0.05),6 min步行距离较对照组明显延长(P<0.05),心率较对照组明显下降(P<0.05)。结论短程大剂量地塞米松辅助治疗重度烧伤合并急性呼吸窘迫综合征患者,可有效改善心肺功能,有助于改善预后。

Objective To study the short- range high- dose dexamethasone adjuvant therapy for severe burns complicated by acute respi- ratory distress syndrome （ARDS） the influence of cardiopulmonary function. Methods 40 cases of severe burns complicated by ARDS patients were randomLy divided into observation group and control group,20 cases in each group,two groups were given rehydration,tra- cheotomy,mechanical ventilation,anti-infection and nutrition support and symptomatic treatment,both groups with dexamethasone therapy, observation group I static drops every four hour,80 rag/times and lasts 1 d;Control static drops once every eight hours,40 rag/times, for 3 d. Compare two groups of patients with cardiopulmonary function changes. Results the FEV~, FVC, FEV~/FVC observation group were compared ~vith the control g^oup improved significantly （P 〈 O. 05）,significantly extended 6 rain walking distance from the control group （P 〈 O. 05）, and heart rate compared with the control group significantly decreased （P 〈 O. 05）. Conclusion short-range high- dose dexamethasoue adjuvant therapy in patients with severe burns complicated by acute respiratory distress syndrome,which can effectively improve cardiopulmonary function,help to improve the prognosis.