摘要
目的观察重组人生长激素(rhGH)治疗老年胸腹部术后急性呼吸衰竭的疗效及安全性。方法将46例老年胸腹部术后急性呼吸衰竭患者随机分为2组,治疗组(23例)采用rhGH与机械通气联合治疗,予rhGH4U,2次/d,肌内注射,连续治疗7d;对照组(23例)采用机械通气治疗。2组其他治疗相同。观察2组治疗后,机械通气时间、一次拔管成功率、呼吸机相关肺炎发生率、平均住ICU时间、ICU病死率及第7天时患者血清白蛋白、总蛋白含量,血糖含量、每日胰岛素用量。结果 2组比较,治疗组在机械通气时间、平均住ICU时间明显缩短(P<0.05);一次拔管成功率、呼吸机相关肺炎发生率、ICU病死率优于对照组(P<0.05)。治疗前2组患者血清白蛋白、总蛋白浓度差异无统计学意义(P>0.05);治疗7d后较对照组差异有统计学意义(P<0.05)。治疗前2组患者血糖均高于正常,但2组比较差异无统计学意义(P>0.05),治疗组治疗后血糖较治疗前均有升高,但差异无统计学意义(P>0.05)。结论 rhGH用于老年胸腹部术后急性呼吸衰竭可改善营养状况,明显减少呼吸机治疗的时间,减少患者在ICU的病死率,但治疗期间应加强血糖的监测,强化胰岛素治疗,防止糖代谢紊乱发生。
Objective To explore the effect and safety of rhGH on acute respiratory failure after thoracic and abdominal operation in elderly patients. Methods 46 elderly patients with acute respiratory failure after thoracic and abdominal operation were randomly divided into two groups. The 23 patients in treatment group were treated by rhGH combined with mechanical ventilation, with rhGH 4U, intramuscular injection, twice a day for 7 days;the other 23 patients in control group were treated by mechanical ventilation. The mechanical ventilation time,average staying time in ICU, success rate of one time extubation, the incidence of ventilator associated pneumonia and case fatality rate in ICU were observed for both groups. The contents of serum albumin, total protein, blood glucose and the insulin dosage per day were detected. Results The mechanical ventilation time and average staying time in ICU in treatment group were significantly shortened, as compared with those in control group （ P 〈 0.05 ）, and success rate of one time extubation, the incidence of ventilator associated pneumonia and case fatality rate in ICU in treatment group were superior to those in control group （ P 〈 0. 05 ）. There were no significant differences in the contents of serum albumin and total protein before treatment between two groups （ P 〉 0.05 ）, however, there were significant differences after 7 - day treatment between two groups （ P 〈 0.05 ）. Before treatment the levels of blood glucose in both groups were higher than those of healthy subjects, however, there were no significant differences between two groups （ P 〉 0.05）. After treatment the levels of blood glucose in treatment group were increased, as compared with those before treatment, but there were no significant differences （P 〉 0.05 ）. Conclusion The application of rhGH in treatment of acute respiratory failure after thoracic and abdominal operation in elderly patients can improve patients＇ nutritional status, decrease the time of mechanical ventila
出处
《河北医药》
CAS
2012年第22期3365-3367,共3页
Hebei Medical Journal
基金
十堰市科学技术研究与发展攻关计划项目(编号:2009045D)
