摘要
目的:研究右美托咪定对脓毒症致急性呼吸窘迫综合征(ARDS)患者血浆高敏C反应蛋白(hs-CRP)、降钙素原(PCT)、白介素-6(IL-6)、胸腔液体水平(TFC)及氧合指标的影响。方法:选择2016年2月至2018年2月重症医学科收治的脓毒症致ARDS患者62例,采用简单随机数字表法将其分为观察组(32例)和对照组(30例),在常规机械通气治疗基础上,对照组给予咪达唑仑镇静治疗,观察组给予右美托咪定镇静治疗,两组均联合芬太尼行充分镇痛,记录并比较两组患者临床疗效、治疗前后血浆hs-CRP、PCT、IL-6、TFC、氧合指标及急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、ICU住院时间、撤机时间、病死率。结果:治疗后,观察组的临床总有效率显著高于对照组(P <0.05);观察组患者的血浆hs-CRP、PCT、IL-6、TFC、APACHEⅡ评分降低幅度明显高于对照组(P <0.05),SaO2、PaO2、PaO2/Fi O2水平升高幅度明显高于对照组(P<0.05),观察组ICU住院时间、撤机时间明显短于对照组,病死率显著低于对照组(P<0.05)。结论:右美托咪定镇静可下调脓毒症致ARDS患者血浆hs-CRP、PCT、IL-6、TFC水平,减轻炎症反应,改善氧合指标,缩短ICU住院时间,降低病死率。
Objective:To study the effects of dexmedetomidineon the plasma high sensitive C reactive protein(hs-CRP),procalcitonin(PCT),interleukins(IL-6),thoracic Fluid(TFC)levels and Oxygenation of Patients with ARDS Induced by Sepsis.Methods:A total of 62 ARDS patients with sepsis admitted to intensive care unit from February 2016 to February 2018 were divided into observation group(n =32)and control group(n = 30)by simple random number table method.On the basis of conventional mechanical ventilation,the control group was given midazolam sedative treatment,while the observation group was given dexmedetomidine sedative treatment,they were combined with fentanyl for analgesia.The clinical efficacy and levels of plasma hs-CRP,PCT,IL-6,TFC,oxygenation index and acute physiology and chronic health scoring system II(APACHE II)score before and after treatment and the ICU length of stay,weaning time and fatality ratewere recorded.Results:After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).The reduction amplitude of the plasma hs-CRP,PCT,IL-6,TFC,APACHE II scores in the observation group were significantly higher than those in the control group(P<0.05),the increase amplitude of the SaO2,PaO2 PaO2/FiO2 were also significantly higher than those of the control group(P<0.05).The ICU length of stay and weaning time of the observation group were significantly shorter than those of the control group,and the mortality was significantly lower than that of the control group(P<0.05).Conclusion:Dexmedetomidine sedation can reduce the levels of hs-CRP,PCT,IL-6 and TFC in plasma of sepsis-induced ARDS patients,alleviate inflammation,improve oxygenation index,shorten ICU hospitalization time and reduce mortality.
作者
郑春
简万均
朱俊
ZHENG Chun(Neijiang Municipal First Peoplel's Hospital,Sichuan Neijiang 641000,China)
出处
《河北医学》
CAS
2019年第1期94-99,共6页
Hebei Medicine
基金
四川省科技计划项目
(编号:20130153)
关键词
右美托咪定
脓毒症
急性呼吸窘迫综合征
炎症因子
胸腔液体水平
氧合指标
Dexmedetomidine
Sepsis
ARDS
Acute respiratory distress syndrome
Inflammatory factors
Thoraciefluid content
Oxygenation
