厚朴排气合剂联合西甲硅油治疗机械通气并发腹胀患者的临床分析

The clinical analysis of Magnolia exhaust mixture combined with simethicone on mechanical ventilation patients with abdominal distension

[目的]观察厚朴排气合剂联合西甲硅油治疗机械通气患者腹胀的临床疗效。[方法]选取2011年1月~2013年12月我院ICU收治的80例机械通气合并腹胀的患者,按照随机数字原则将患者分为观察组和对照组,每组各40例。对照组患者给予西甲硅油乳剂,5ml/次,3次/d;观察组患者在对照组基础上给予鼻饲厚朴排气合剂,50ml/次,2次/d。2组患者均治疗2d。观察2组肠鸣音恢复正常时间、腹内压、APACHEⅡ评分、呼吸机上潮气量、肺的顺应性、气道平台压参数值改善情况。[结果]治疗后,观察组肠鸣音恢复时间、肛门排气时间明显优于对照组,差异有统计学意义（均P〈0.01）;观察组腹内压测量值明显优于对照组,差异有统计学意义（P〈0.01）;观察组APACHEⅡ评分明显优于对照组,差异具有统计学意义（P〈0.05）;观察组呼吸机上潮气量、肺的顺应性、气道平台压参数值改善程度均明显优于对照组,差异均有统计学意义（P〈0.05）;观察组总有效率为87.5%,对照组总有效率为7.5%,差异有统计学意义（P〈0.05）。[结论]厚朴排气合剂联合西甲硅油可有效减轻机械通气并发腹胀患者的临床症状和体征,值得临床推广使用。

[Objective]To observe the clinical effects of Magnolia Exhaust Mixture combined with simethicone treatment on mechanical ventilation patients with abdominal distension.[Methods]A total of 80 mechanical ventilation patients with abdominal distension in our hospital were selected between January,2011 and June,2013 and then were randomly divided into two groups（n=40）：control group and observation group.The patients in control group were given simethicone,5ml/time,3times/day.while the patients in observation group were given Magnolia exhaust mixture,50 ml/time,2times/day based on control group.Two groups of patients were treated for two days.Duration for bowel sounds to return to normal,intra-abdominal pressure,APACHE II score,tidal volume,lung compliance,airway plateau pressure were observed.[Results]Recovery time of bowel sounds,anal exhaust time in observation group were significantly better than those in the control group,the difference was statistically significant（P〈0.01）;Intra-abdominal pressure measurements in observation group was better than the control group,the difference was statistically significant（P〈0.01）;APACHE II score of observation group was significantly better than the control group,the difference was statistically significant（P〈0.05）;The ventilator tidal volume,lung compliance,airway plateau pressure values,and the degree of improvement in observation group were significantly better than the control group,the differences were statistically significant（P〈0.01 or 0.05）;The total effective rate was 87.5%in the observation group and 7.5%in control group,the difference was sta-tistically significant（P〈0.05）.[Conclusion]Magnolia exhaust mixture combined with simethicone can effectively reduce the clinical signs and symptoms,which is worthy of clinical use.