山莨菪碱联用地塞米松治疗术后并发多器官功能障碍综合征的临床研究方案  

Clinical investigation and scheme for the treatment of abdominal surgery disease complicated with multiple organ dysfunction syndrome, through combining use of anisodamine and dexamethasone

作　　者：岳茂兴[1] 

机构地区：[1]解放军第三○六医院,北京100101

出　　处：《中国中西医结合急救杂志》2004年第5期264-267,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：北京科技计划重大项目分课题 ( 2 0 0 2 0 2 3 0 6)

摘　　要：目的 :探讨山莨菪碱联用地塞米松治疗术后并发多器官功能障碍综合征 (MODS)患者的效果。方法 :采用多中心、前瞻性、随机对照临床研究方法 ,拟收集和分析 30 0例腹部外科疾病患者术后并发 MODS的防治情况。山莨菪碱用法为每次 0 .33m g/ kg、每日 3次 ,地塞米松用法为每次 0 .33mg/ kg、每日 3次 ,采用静脉滴注或静脉推注方法 ,连用 3d。评价联用山莨菪碱和地塞米松治疗需手术 MODS患者的治疗方案是否能使MODS抢救成功率进一步提高 ,病死率降低。结果 :已统计的 71例中 ,常规治疗组 2 6例 ,死亡 13例 ,病死率为5 0 .0 % ;地塞米松组 2 2例 ,死亡 5例 ,病死率为 2 2 .7% ;地塞米松和山莨菪碱联用组 2 3例 ,死亡 4例 ,病死率为17.4 %。结论 :已有的 71例资料显示 ,山莨菪碱联用地塞米松能遏制患者的危重状态 ,为紧急手术和下一步的治疗赢得时间 ,降低病死率 ,且对重要脏器无损伤作用 ,其机制待前瞻性研究的 30 0例患者资料予以阐述。Objective: To investigate the e ffects of the treatment of the abdominal surgery disease complicated with mu ltiple organ dysfunction syndrome (MODS) through combining use of anisodamine and dexamethas one. Methods: Based on multiple centers, prospective and random clinical investigations, the preventive and treatment effects were analyzed in 300 cases with abdominal s urg ery disease complicated with MODS. Anisodamine and dexamethasone were administrated respectively through intraveno usly injection 033 mg/kg, 3 times a day for 3 days. It was observed that if the treatment of abdominal surgery complicated with MODS by combining use of anisod amine and dexamethasone could increase the therapeutic effects and decreas e the mortality significantly. Results: The mortality rates were 500%(13 cases died) in 26 cases of conventional t reatment group, 227%(5 cases died) in 22 cases of dexamethason treatment gro up, and 174 %(4 cases died) in 23 cases of anisodamine combined dexamethaso n treatment group. Conclusion: MODS is characterized with complicated etiological factors, unsatisfactory thera peutics effect and high mortality. The analysis of 71 cases' data shows that the combined use of anisodamine and dexameth asone could relieve the critical and severe dysfunctions of the important organs , make it possible for the further operation or other treatment and decrease th e mortality significantly. Generally they do no harm to the vital organs. The me chanisms will be investigated in the prospective study of 300 cases later.

关 键 词：腹部外科疾病 多器官功能障碍综合征 山莨菪碱 地塞米松 联合治疗 

分 类 号：R459.7[医药卫生—急诊医学]