大承气汤对腹腔间隔室综合征并机械通气患者呼吸力学影响

Effect of Dachengqi Decoction on Respiratory Mechanics in Patients with Abdominal Compartment Syndrome and Mechanical Ventilation

目的观察大承气汤对腹腔间隔室综合征患者呼吸力学影响。方法 54例患者发生腹腔间隔室综合征并行机械通气患者,按转入ICU的先后顺序,按照事先由随机数确定的随机分组方法,进入治疗组和对照组。治疗组在西药治疗原发病基础上,入组后即开始予口服大承气汤治疗。比较2组腹腔内压、腹腔灌注压、动脉血氧合指数、动脉血二氧化碳分压、气道平均压、肺静态顺应性、气道阻力、SOFA 评分、C反应蛋白水平。结果 2组治疗后较治疗前腹腔内压下降、腹腔灌注压上升、动脉血氧合指数上升、动脉血二氧化碳分压下降、气道平均压下降、肺静态顺应性上升、气道阻力下降、SOFA评分下降、C反应蛋白水平下降,与治疗前比较差异有统计学意义(P<0.05)。治疗组较对照组改变更明显(P<0.05)。结论应用大承气汤治疗腹腔间隔室综合征可降低腹腔内压,增加腹腔灌注压,并能改善呼吸力学和血气分析指标。

Objective To observe the effect of Dachengqi decoction on respiratory mechanics in patients with abdominal compartment syndrome and mechanical ventilation.Methods Fifty-four patients with abdominal compartment syndrome and mechanical ventilation were entered into the treatment group and the control group according to the sequence of turning into ICU and the random grouping method determined by the random number at first.The treatment group was given Dachengqi decoction on the basis of the treatment of underlying disease by western medicine.Blood gas analysis index,respiratory mechanics index,intra-abdominal pressure,abdominal perfusion pressure,respiratory mechanic and SOFA score were compared between the two groups.Results After treatment,the arterial oxygenation index increased,the carbon dioxide partial pressure dropped,the airway mean pressure dropped,the lung static compliance increased,the airway resistance decreased,and the SOFA score decreased in the treatment group and the control group than before,and the difference was statistically significant(P<0.05).Compared with the control group,the change in treatment group was more obvious and the difference was statistically significant(P<0.05).Conclusion Dachengqi decoction is effective in treating abdominal compartment syndrome and can improve respiratory mechanics.