摘要
目的探讨前列地尔对感染性休克并急性呼吸窘迫综合征(ARDS)患者的临床效果。方法选取2015年2月~2018年11月解放军第九六四医院收治的81例感染性休克并ARDS患者,采用随机数字表法将患者分为对照组(n=40)和研究组(n=41),对照组给予常规治疗,研究组在对照组基础上联合前列地尔治疗。比较两组患者临床指标、呼吸功能指标、炎性因子指标情况,记录两组治疗期间不良反应发生情况。结果研究组机械通气时间、ICU住院时间、总住院时间均短于对照组(P<0.05),而两组病死率比较,差异无统计学意义(P>0.05)。两组患者治疗2、3d后氧合指数(OI)、动脉氧分压(PaO2)呈升高趋势,呼吸频率(RR)呈下降趋势(P<0.05),研究组治疗2、3d后RR低于对照组,PaO2、OI高于对照组(P<0.05)。两组患者治疗3d后白介素-6、降钙素原、C反应蛋白、肿瘤坏死因子-α水平均下降,且研究组低于对照组(P<0.05)。两组患者不良反应比较,差异无统计学意义(P>0.05)。结论前列地尔治疗感染性休克并ARDS患者,可有效改善机械通气时间、ICU住院时间、总住院时间,且不增加不良反应发生率,这可能与其改善呼吸功能、炎性反应有关。
Objective To investigate the clinical effect of Alprostadil on septic shock with acute respiratory distress syndrome (ARDS). Methods From February 2015 to November 2018, 81 cases of ARDS with infectious shock in PLA 964th Hospital were selected, patients were randomly divided into control group (n = 40) and study group (n = 41) by random numerber table method. The control group was given conventional treatment, and the study group was treated with Alprostadil on the basis of the control group. Clinical indicators, respiratory function indicators and inflammatory factor indicators of the two groups were compared, and adverse reactions in the two groups during treatment were recorded. Results Mechanical ventilation duration, length of stay in ICU and total length of stay in the study group were shorter than those in the control group (P < 0.05). However, there was no statistically significant difference in mortality between the two groups (P > 0.05). OI and PaO2 showed a trend of increase and RR showed a trend of decrease after 2 and 3 days of treatment (P < 0.05). RR in the study group was lower than that in the control group after treatment for 2 and 3 d, while PaO2 and OI were higher than that in the control group (P < 0.05). The levels of interleukin-6, procalcitonin, C-reactive protein and tumor necrosis factor-α in both groups decreased after 3 d of treatment, and the levels in the study group were lower than those in the control group (P < 0.05). The difference in adverse reactions between the two groups was no statistically significant (P > 0.05). Conclusion Alprostadil can effectively improve mechanical ventilation time, length of ICU stay, and total length of stay in ARDS patients with septic shock without increasing the incidence of adverse reactions, which may be related to the improvement of respiratory function and inflammatory response.
作者
王志
刘野
滕乐
孟醒
WANG Zhi;LIU Ye;TENG Le;MENG Xing(Department of Critical Care Medicine,PLA 964th Hospital,Jilin Province,Changchun 130062,China)
出处
《中国医药导报》
CAS
2019年第27期118-121,共4页
China Medical Herald
基金
吉林省科技发展计划项目(20130206034SF)
