摘要
目的探讨糖皮质激素联合机械通气对肺挫伤患者肺表面活性物质和动脉血气的影响。方法采用常规治疗(对照组)和糖皮质激素联合机械通气(治疗组)治疗肺挫伤,观察患者在治疗前、治疗24 h后、治疗7 d后的动脉血气分析指标和治疗前后肺表面活性蛋白D(surfactant-associated protein D,SP-D)水平,比较2组治疗效果及预后。结果治疗后,2组患者动脉血气分析指标和SP-D水平均有明显改善,且治疗组优于对照组,差异有统计学意义(P<0.05)。治疗7 d后,治疗组治疗优良率(92.86%)高于对照组(77.19%),差异有统计学意义(χ^(2)=5.423,P=0.020)。治疗组机械通气时间短于对照组,治愈出院人数多于对照组,死亡人数少于对照组,差异均有统计学意义(P<0.05);2组转出患者人数差异无统计学意义(P>0.05)。结论糖皮质激素联合机械通气能减轻肺挫伤患者肺水肿,促进不张的肺膨胀,促进肺表面活性物质的产生,改善肺通气和肺换气,纠正低氧血症。
Objective To investigate the effects of glucocorticoid combined with mechanical ventilation on pulmonary surfactant and arterial blood gas in patients with pulmonary contusion.Methods Pulmonary contusion were treated with routine treatment(control group)and glucocorticoid combined with mechanical ventilation(treatment group).Arterial blood gas analysis and surfactant-associated protein D(SP-D)level were observed before treatment,24 hours after treatment and 7 days after treatment.The therapeutic effect and prognosis of the two groups were compared.Results After treatment,the arterial blood gas analysis index and SP-D level of the two groups were improved,and the treatment group was better than the control group(P<0.05).After 7 days of treatment,the excellent and good rate in the treatment group(92.86%)was higher than that in the control group(77.19%),and the difference was statistically significant(χ^(2)=5.423,P=0.020).The time of mechanical ventilation in the treatment group was shorter than that in the control group,the number of cured and discharged patients in the treatment group was more than that in the control group,and the number of deaths in the treatment group was less than that in the control group(P<0.05).There was no significant difference in the number of patients transferred out between the two groups(P>0.05).Conclusions Glucocorticoid combined with mechanical ventilation can reduce pulmonary edema,promote atelectasis,promote the production of pulmonary surfactant,improve pulmonary ventilation and ventilation,and correct hypoxemia.
作者
张骏
易清
汪正权
刘洋
ZHANG Jun;YI Qing;WANG Zhengquan;LIU Yang(EICU,the People's Hospital of Yuyao,Ningbo 315400,China;Baichuan Biotechnology Limited Company of Zhejiang Province,Hangzhou 311200,China)
出处
《健康研究》
CAS
2021年第5期568-571,共4页
Health Research
关键词
肺挫伤
机械通气
糖皮质激素
血气分析
肺表面活性蛋白D
pulmonary contusion
mechanical ventilation
glucocorticoid
blood gas analysis
surfactant-associated protein D
