足三里注射黄芪注射液联合呼吸机治疗银环蛇毒导致呼吸抑制的临床研究

Clinical study on Treatment of Respiratory Suppression Caused by Bungarotoxin by Tsusanli Inject of Astragalus injection Combined with Ventilator

目的观察足三里穴位注射黄芪注射液联合呼吸机治疗银环蛇毒引起呼吸抑制的临床疗效。方法选择34例银环蛇咬伤后出现自主呼吸抑制的患者为研究对象,随机分为两组,对照组予银环蛇咬伤常规治疗措施,包括应用呼吸机、抗蛇毒血清及糖皮质激素等;观察组在对照组的治疗基础上给予足三里注射黄芪注射液,观察比较两组患者的临床疗效。结果在开始治疗24h时,观察组患者呼吸功能主要指标(pH值、PaO_2、PaCO_2)均优于对照组,差异有统计学意义(P<0.05);观察组患者在呼吸机支持模式更换时间上(由A/C模式转换为SPONT模式)明显早于对照组,在机械通气时间、重症监护病房停留时间较对照组明显缩短,在呼吸机相关性肺炎(VAP)发生率方面明显低于对照组,差异均有统计学意义(P<0.05);治疗后,观察组患者的显效率明显高于对照组,差异有统计学意义(P<0.05)结论联合应用足三里穴位注射黄芪注射液和呼吸机治疗银环蛇毒导致的呼吸抑制,能促进患者尽快回复自主呼吸,快速改善患者氧合指标,减少VAP的发生,有利于病情的快速控制,提高临床疗效。

Objective To observe the clinical efficacy of Tusuanli inject of Astragalus injection combined with ventilator in the treatment of respiratory depression caused by bungarotoxin. Methods Thirty-four patients with spontaneous respiratory depression caused by bungarotoxin were selected as the study subjects and randomly divided into two groups.The control group received routine treatment of Bungarus multicinctus bites,including the use of ventilator,anti-venom serum and glucocorticoid.ect.The observation group was given Tsusanli injection of Astragalus injection on the basis of the treatment of the control group,and the clinical efficacy indexes of the two groups were compared. Results In the treatment of 24 h,the main indexes of respiratory function（pH,PaO_2,PaCO_2）in the observation group were better than those in the control group,and the difference was statistically significant（P〈0.05）.In the observation group,the replacement time of ventilator support mode（from A/C mode to SPONT mode）was significantly earlier than that of the control group.The duration of mechanical ventilation and the length of stay in ICU were significantly shorter than those in the control group.The incidence of ventilatorassociated pneumonia（VAP）in the observation group was significantly lower than that in the control group（P〈0.05）.The effective rate of the observation group was significantly higher than that of the control group.The difference was statistically significant（P〈0.05）. Conclusion The combined use of Tsusanli injection of Astragalus injection and ventilator to treat respiratory depression caused by the bungarotoxin can promote early recovery of patient＇s spontaneous respiration,rapidly improve the patient＇s oxygen and index,reduce the occurrence of VAP,facilitate the rapid control of the disease condition,improve the clinical efficacy.