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目的 :研究脂微球前列腺素E1 (lipo PGE1 )对急性呼吸窘迫综合征 (ARDS)患者血流动力学、呼吸力学、动脉血气的影响 ,评估其疗效。方法 :2 0 0 0年 1月～ 2 0 0 3年 8月收治ARDS患者 5 8例 ,随机分lipo PGE1 治疗组 ( 3 0例 )和对照组 ( 2 8例 )。治疗组在入院 48h后静脉滴注lipo PGE1 3ng·kg-1 ·min-1 ,维持 2h ,每天 2次 ,连用 7～ 14d。比较血流动力学、呼吸力学、动脉血气、机械通气时间、住ICU时间及生存率。结果 :治疗组生存率显著高于对照组 (P <0 0 5 ) ,其机械通气时间、患者住ICU时间显著低于对照组(P <0 0 1)PaO2 、氧合指数 (氧分压 /吸氧分数 )、肺顺应性恢复较对照组早 (P <0 0 1,P <0 0 5 ,P <0 0 5 )lipo PGE1 有效降低肺动脉压和肺血管阻力、增加心排量。结论 :lipo PGE1 对ARDS患者有较好疗效 ,提高生存率 ,缩短住ICU时间
Objective: To study the effects of lipo PGE1 on hemodynamics, respiratory mechanics and arterial blood gases in patients with acute respiratory distress syndrome (ARDS). Methods: From January 2000 to August 2003, 58 patients with ARDS were randomly divided into two groups: the lipo PGE1 group (30 cases) and the control group (28 cases). The treatment group were given intravenous infusion of lipo PGE1 3ng · kg-1 · min-1 48h after admission, maintained for 2h, twice daily for 7 ~ 14d. Compare hemodynamics, respiration mechanics, arterial blood gas, mechanical ventilation time, ICU stay time and survival rate. Results: The survival rate of the treatment group was significantly higher than that of the control group (P <0 05). The duration of mechanical ventilation and ICU stay in the treatment group was significantly lower than that of the control group (P <0.01) PaO2, oxygenation index (P <0.01, P <0.05, P <0.05). Lipo PGE1 effectively reduced pulmonary arterial pressure and pulmonary vascular resistance and increased cardiac output. Conclusion: lipo PGE1 has a good effect on patients with ARDS, improve survival rate and shorten ICU time