摘要
目的 :观察静脉应用脂微球—前列腺素E1 (lipo PGE1 )治疗急性肺挫伤疗效。方法 :将1998年 1月— 2 0 0 0年 10月共救治严重多发性创伤合并肺挫伤病人 (ISS≥ 2 0 ) 74例 ,随机分为lipoPGE1 治疗组 (38例 )和常规治疗组 (36例 )。两组患者均因严重低氧血症行机械通气。治疗组在入院 2 4小时后静脉注射lipo PGE1 3ng .kg- 1 .min- 1 持续 2小时停止 ,每天 2次 ,连用 7天。从呼吸机通气时间 ,病人住ICU治疗时间 ,胸部X线恢复情况 ,氧分压 ,氧合指数恢复情况进行疗效比较。结果 :在治疗后 72h内 ,lipo PGE1 能明显减少肺挫伤病人胸部进一步渗出 ,提高急性肺挫伤患者氧分压 ,氧合指数 (P <0 0 5 ) ;降低呼吸机通气时间 ,病人住ICU时间 ,两组比较差异非常显著 ,(P <0 0 0 1)。结论 :lipoPGE1 对急性肺挫伤有较好疗效 ,能明显促进肺部修复 ,提高肺组织氧合能力 ,改善预后 ,缩短病人住ICU时间 。
Objective To study the therapeutic effect of liposomal prostaglandin E 1(lipo PGE 1)on severe pulmonary contusion.Methods From January 1998 to August 2000 seventy four patients (ISS≥20)with severe pulmonary contusion were selected in the study.The patients were mechanically ventilated because of severe hypoxia.They were divided randomly into two groups:control group and lipo PGE 1 group.In the control group( n =38)the patients were treated only with routine therapy.In lipo PGE 1 group( n =36)they received an intravenous bolus of lipo PGE 1 followed by a dose of 3ng.kg -1 .min -1 infusion of 2h and q12h for 7 days.Results In the lipo PGE 1 group,the total duration of assisted ventilation was less than that in the control group( P <0 001).The average stay in the intensive care unit of lipo PGE 1 group was lower than that in the control group( P <0 001).Blood gas analyses(PaO 2,PaO 2/FiO 2)of the patients from the PGE 1 group was improved(p<0 01)after treatment within 72h,but that from the control group was not improved( P <0 05).From X rays,the inflammatory change of lung recovered sooner in the lipo PGE 1 group than it did in the control groups.Conclusion The treatmemt of pulmonary contusion by lipo PGE 1,resulted in speedy recovery,better ultimate pulmonary functions,and it proved to be cost effective. [
出处
《中华急诊医学杂志》
CAS
CSCD
2002年第5期334-336,共3页
Chinese Journal of Emergency Medicine
