参附注射液联合经面罩机械通气治疗对急性心源性肺水肿患者微循环的影响

Influence of Shenfu Injection combined with mechanical ventilation via face mask on microcirculation in patients with acute cardiogenic pulmonary edema

目的探讨参附注射液联合经面罩机械通气治疗(MVFM)对急性心源性肺水肿患者微循环的影响。方法选取64例急性心源性肺水肿患者,随机分为对照组与参附组,每组32例。对照组给予规范化药物治疗联合MVFM治疗,参附组在对照组基础上给予参附注射液治疗。比较2组患者治疗前及治疗6 h后、24 h后、1周后中心静脉血氧饱和度、氧合指数、动脉血乳酸清除率、中心静脉压(CVP)和平均动脉压(MAP)。结果 2组患者治疗6 h、24 h、1周后的中心静脉血氧饱和度、氧合指数、CVP与MAP均显著优于治疗前(P <0. 05),2组治疗24 h、1周后的乳酸清除率显著高于治疗前(P <0. 05)。参附组患者治疗6 h、24 h、1周后的中心静脉血氧饱和度、氧合指数与MAP均显著高于对照组(P <0. 05),治疗24 h、1周后的乳酸清除率显著高于对照组(P <0. 05)。参附组治疗6 h、24 h、1周后的CVP显著低于对照组(P <0. 05)。参附组患者治疗期间无不良反应。结论参附注射液联合MVFM能显著改善急性心源性肺水肿患者的缺氧状态,增加组织灌注,改善微循环。

Objective To investigate the influence of Shenfu Injection combined with mechanical ventilation via face mask(MVFM)on microcirculation in patients with acute cardiogenic pulmonary edema.Methods Totally 64 patients with acute cardiogenic pulmonary edema were randomly divided into control group(n=32)and Shenfu group(n=32).The control group was treated with standardized medication and MVFM,while the Shenfu group was treated with Shenfu Injection on the basis of the control group.The central venous oxygen saturation,oxygenation index,arterial lactate clearance rate,central venous pressure(CVP)and mean arterial pressure(MAP)were compared between the two groups before treatment and 6 h24 h and 1 week after treatment.Results The central venous oxygen saturation,oxygenation index,CVP and MAP in both groups after 6 h,24 h and 1 week of treatment were significantly better than those before treatment(P<0.05).The lactate clearance rates in both groups after 24 h and 1 week of treatment were significantly higher than those before treatment(P<0.05).The central venous oxygen saturation,oxygenation index and MAP in the Shenfu group were significantly higher than those in the control group at 6 h24 h and 1 week after treatment(P<0.05),and the lactate clearance rates after 24 h and 1 week of treatment were significantly higher than those in the control group(P<0.05).CVP in Shenfu group was significantly lower than that in control group after 6 h24 h and 1 week of treatment(P<0.05).No adverse reactions occurred during treatment in Shenfu group.Conclusion Shenfu Injection combined with MVFM can significantly improve the hypoxic state,increase tissue perfusion and improve microcirculation in patients with acute cardiogenic pulmonary edema.