用山莨菪碱抢救肺弥漫性出血型钩端螺旋体病的27例分析

Analysis of Anisodamine in Rescuing 27 Cases of Patients with Leptospirosis with Diffuse Pulmonary Bleeding

目的探讨山莨菪碱在肺弥漫性出血型钩端螺旋体病患者抢救中的应用效果。方法回顾分析该院2011年1月—2013年12月收治的、应用机械通气联合常规治疗抢救的23例肺弥漫性出血型钩端螺旋体病患者的临床资料,并将该组患者设为对照组,将该院2014年1月—2016年7月期间收治的27例肺弥漫性出血型钩端螺旋体病患者设为观察组,对观察组患者实施机械通气+常规治疗+山莨菪碱抢救,对比两组患者的抢救成功率、实施抢救前后的生命体征。结果观察组患者的抢救成功率为88.89%,高于对照组患者的69.57%(P<0.05)。两组中抢救成功患者抢救前的生命体征(Sa O2、Pa O2、MAP、HR)检测结果比较存在的差异无统计学意义(P>0.05),实施抢救后观察组患者Sa O2、Pa O2、MAP、HR分别为(93.16±3.49)%、(79.15±7.63)%、(81.26±4.91)mm Hg、(80.46±8.01)次/min,与对照组患者的(87.36±4.01)%、(73.29±7.58)%、(92.16±5.33)mm Hg、(91.90±6.08)次/min比较差异有统计学意义(P<0.05)。结论山莨菪碱在肺弥漫性出血型钩端螺旋体病患者抢救治疗中的应用,能够有效提高患者抢救成功率,进一步改善患者预后。

Objective To observe the application effect of anisodamine in rescuing leptospirosis with diffuse pulmonary bleeding. Methods 23 cases of patients with leptospirosis with diffuse pulmonary bleeding treated in our hospital from January2011 to December 2013 were selected as the control group and used the mechanical ventilation combined with routine treatment,while 27 cases of patients with leptospirosis with diffuse pulmonary bleeding admitted and treated in our hospital from January2014 to July 2016 were selected as the observation group and adopted the mechanical ventilation and routine treatment combined with anisodamine, and the success rate of rescue and vital signs before the implementation of rescue of the two groups were compared. Results The rescue success rate in the observation group was higher than that in the control group(88.89% vs 69.57%)(P<0.05), and the differences in the vital sign test results(Sa O2,Pa O2,MAP,HR)between the two groups were not statistically significant(P>0.05), after rescue, there were obvious differences in the Sa O2,Pa O2,MAP,HR between the observation group and the control group were obvious [(93.16 ±3.49)%,(79.15 ±7.63)%,(81.26 ±4.91)mm Hg,(80.46 ±8.01)times/min vs(87.36 ±4.01)%,(73.29 ±7.58)%,(92.16±5.33)mm Hg,(91.90±6.08)times/min](P<0.05). Conclusion The application of anisodamine in rescuing leptospirosis with diffuse pulmonary bleeding can effectively improve the rescue success rate of patients and further improve the prognosis.