摘要
目的观察鼻饲大黄辅助治疗对急性肺损伤(acute lung injury,ALI)患者临床症状及预后水平的改善作用。方法以2018年2月—2020年2月温州市中西医结合医院收治的128例ALI患者为研究对象,按照随机数字表法分为对照组(64例)和研究组(64例),对照组患者给予常规治疗,研究组患者在此基础上予以鼻饲大黄辅助治疗,检测患者治疗前后血清hs-CRP、TNF-α、IL-6和IL-8水平,记录机械通气时间,统计治疗前后呼吸频率、动脉血氧分压和氧合指数,观察患者治疗期间急性呼吸窘迫综合征(ARDS)和死亡发生情况。结果研究组治疗后血清hs-CRP,TNF-α、IL-6和IL-8含量均显著低于对照组(均P<0.05);研究组治疗后呼吸频率[(24.81±2.64)次/min]显著低于对照组[(27.64±2.79)次/min],而PaO_(2)[(78.35±6.63)mm Hg,1 mm Hg=0.133 kPa]和氧合指数(314.20±42.17)高于对照组[(70.26±6.21)mm Hg,263.07±39.60,均P<0.05];研究组机械通气时间[(4.27±1.39)d]显著短于对照组[(6.95±1.81)d,t=-4.971,P<0.001];研究组ARDS发生率和死亡率(18.75%、3.12%)显著低于对照组(39.06%、14.06%,χ^(2)=6.425、4.873,P=0.011、0.027)。结论鼻饲大黄辅助治疗可有效抑制ALI患者炎症反应,促进呼吸功能及血气指标恢复,防止病情恶化。
Objective To observe the effect of nasal feeding rhubarb on the improvement of clinical symptoms and prognosis of patients with acute lung injury(ALI).Methods A total of 128 patients with ALI were selected as the research subjects.All subjects were divided into the control group(n=64)and the research group(n=64)using the random number table method.The patients in the control group were given routine treatment,whereas the patients in the research group were given adjuvant treatment of rhubarb by nasal feeding on the basis of routine treatment.The hs-CRP,TNF-α,IL-6 and IL-8 levels were measured before and after treatment.The time of mechanical ventilation and hospitalisation were recorded.The changes of respiratory frequency,arterial oxygen partial pressure and oxygenation index were counted before and after treatment,and the incidence of ARDS and death was observed during the treatment.Results After treatment,the hs-CRP,TNF-α,IL-6 and IL-8 levels in the research group were significantly lower than those in the control group(all P<0.05).The respiratory rate in the research group[(24.81±2.64)times/min]was significantly lower than that in the control group[(27.64±2.79)times/min],whereas PaO_(2) and oxygenation index in the research group[(78.35±6.63)mm Hg and(314.20±42.17)mm Hg,respectively]were significantly higher than those in the control group[(70.26±6.21)mm Hg and(263.07±39.60)mm Hg,respectively;all P<0.05].The duration of mechanical ventilation in the study group[(4.27±1.39)days]was significantly shorter than that in the control group[(6.95±1.81)days,t=-4.971;P<0.001].The incidence and mortality of ARDS in the study group(18.75%and 3.12%)were significantly lower than those in the control group(39.06%and 14.06%,χ^(2)=6.425,4.873;all P<0.05).Conclusion Rhubarb by nasal feeding can inhibit the inflammatory response of patients with ALI,promote the recovery of respiratory function and blood gas index and prevent the deterioration of the disease.
作者
蒋欢欢
李志军
JIANG Huan-huan;LI Zhi-jun(Department of Respiratory Medicine,Wenzhou Integrated Traditional Chinese and Western Medicine Hospital,Wenzhou,Zhejiang 325000,China;不详)
出处
《中华全科医学》
2021年第1期55-58,共4页
Chinese Journal of General Practice
基金
2018年度浙江省基础公益研究项目(LY18H290008)。
关键词
急性肺损伤
鼻饲
大黄
肺与大肠相表里
炎症反应
临床疗效
Acute lung injury
Nasal feeding
Rhubarb
Lung and large intestine inside and outside
Inflammatory reaction
Clinical effect
