论文部分内容阅读
目的:研究参附注射液联合有创机械通气治疗急性心源性肺水肿的临床效果。方法:急性心源性肺水肿患者40例随机分为治疗组(20)和对照组(20)。对照组采用5%葡萄糖250 m L+硝普钠注射液25 mg,避光静脉输注,(15~50)Lg/min,视血压调整。治疗组在对照组治疗的基础上加用5%葡萄糖250 m L+参附注射液50 m L静脉输注。然后两组病患均给予有创机械通气治疗。治疗期间监测患者治疗后的临床征象、动脉血气分析指标的变化、有创机械通气时间、住院期间、并发症的情况,以及患者治疗后无创血流动力学指标心排血量(CO)、心脏指数(CI)、每搏量(SV)的变化。结果:对照组与治疗组的动脉血气指标RR、PH、Pa O2、Pa CO2、Sa O2与血流动力学指标HR、CO、CVP、CI、SV都较通气前有显著性改善(P<0.05);且治疗组的动脉血气指标RR、PH、Pa O2、Pa CO2、Sa O2与血流动力学指标HR、CO、CVP、CI、SV在通气撤机时与对照组相比较也有显著性改善(P<0.05);除此之外,治疗组的总机械通气时间要显著性低于对照组(P<0.05),发生的VAP病例也显著性低于对照组(P<0.05)。结论:有创机械通气治疗急性心源性肺水肿具有较好的疗效,且在此基础上联合参附注射液能够更好的缓解患者急性症状,缩短机械通气和治疗持续时间,这对其在临床上的应用具有极大的参考价值。
Objective: To study the clinical effect of Shenfu injection combined with invasive mechanical ventilation in the treatment of acute cardiogenic pulmonary edema. Methods: Forty patients with acute cardiogenic pulmonary edema were randomly divided into treatment group (20) and control group (20). The control group was treated with 5% glucose 250 m L + sodium nitroprusside injection 25 mg, light-protected intravenous infusion (15 ~ 50) Lg / min, and the blood pressure was adjusted. The treatment group in the control group based on the treatment plus 5% glucose 250 m L + Shen Fu injection 50 m L intravenous infusion. Then both groups of patients were given invasive mechanical ventilation. During treatment, the clinical signs of patients after treatment, the changes of arterial blood gas analysis index, the time of invasive mechanical ventilation, the duration of hospitalization and complications, and the noninvasive hemodynamics of cardiac output (CO), heart Index (CI), stroke volume (SV) changes. Results: The arterial blood gas indexes RR, PH, Pa O2, Pa CO2, Sa O2 and hemodynamics HR, CO, CVP, CI and SV of the control group and the treatment group were all significantly improved ). The arterial blood gas indexes RR, PH, Pa O2, Pa CO2, Sa O2 and hemodynamics HR, CO, CVP, CI, SV in the treatment group also improved significantly compared with the control group (P <0.05). In addition, the total mechanical ventilation time in the treatment group was significantly lower than that in the control group (P <0.05), and the occurrence of VAP cases was also significantly lower than the control group (P <0.05). Conclusions: Invasive mechanical ventilation in the treatment of acute cardiogenic pulmonary edema has a good curative effect, and on this basis, combined with Shenfu injection can better alleviate the acute symptoms and shorten the duration of mechanical ventilation and treatment, which in the Clinical application has great reference value.