摘要
目的：探讨大黄对重症急性胰腺炎并发急性呼吸窘迫综合征（ＡＲＤＳ）的治疗作用。方法：３１例重症急性胰腺炎并发ＡＲＤＳ患者按收住重症监护病房的时间分成两组，Ⅰ组１５例接受机械通气呼气末正压通气（ＰＥＥＰ）治疗，Ⅱ组１６例在ＰＥＥＰ治疗的基础上加用大黄。监测两组患者的ＰＥＥＰ水平、供氧浓度、血气分析指标、氧输送（ＤＯ２）和血流动力学指标，并比较其多器官功能衰竭（ＭＯＦ）的发生率和病死率。结果：在机械通气ＰＥＥＰ治疗中，Ⅱ组患者所需的ＰＥＥＰ水平和供氧浓度显著低于Ⅰ组患者（Ｐ＜０.０１）；治疗后，两组患者的动脉血氧分压（ＰａＯ２、动脉血氧饱合度（ＳａＯ２）等血气分析指标及ＤＯ２均有所升高，Ⅱ组患者升高更为显著（Ｐ＜０．０１）；Ⅱ组患者的肺内分流率（Ｑｓ／Ｑｔ）较Ⅰ组患者显著降低（Ｐ＜０．０１）；Ⅱ组患者的平均肺动脉压（ＰＡＰｍ）和肺血管阻力（ＰＶＲ）等血流动力学指标也较Ⅰ组患者显著减低（Ｐ＜０．０１）；Ⅰ、Ⅱ盟组患者的ＭＯＦ发生率分别为６０％和２５％，病死率分别为５３％和２５％（Ｐ＜０．０１）。结论：大黄对重症急性胰腺炎并发ＡＲＤＳ疗效显著，能防治ＭＯＦ的发生并降低其病死率。
Background/Aims: To evaluate the therapeutic effects of rhubarb on patients with severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS). Methods: 31 patients suffered from SAP complicated with ARDS were divided into two groups: in group Ⅰ 15 patients were treated with positive end expiratory pressure (PEEP) mechanical ventilation (MV); in group Ⅱ 16 patients were treated with PEEP MV and rhubarb was added. The PEEP level, fraction of inspired oxygen (FiO2), blood gas analysis (BGA) and hemodynamic variables were monitored, and oxygen delivery (DO2) was calculated. The morbidity and mortality of multiple organ failure (MOF) in the two groups were statistically analyzed. Results: After PEEP MV treatment, PEEP level and FiO2 were significantly lower in group Ⅱ than those in group Ⅰ(P<0.01). Although arterial oxygen pressure (PaO2), arterial oxygen saturation (SaO2) and DO2 increased in all patients after treatment, the increase in group Ⅱ was more obvious (P<0.01). Right-to-left shunt (Qs/Qt), mean pulmonary arterial pressure (PAPm), pulmonary vascular resistance (PVR) were significantly lower in group Ⅱ than those in group Ⅰ (P< 0.01). The morbidity and mortality of MOF in group Ⅱ (25% and 25%) were also significantly lower than those in group Ⅰ (60% and 53%, P<0.01). Conclusions: The therapeutic effects of rhubarb on patients with SAP complicated with ARDS was significant, the morbidity and mortality of MOF could be reduced.
出处
《胃肠病学》
2001年第2期94-96,共3页
Chinese Journal of Gastroenterology
