重组人生长激素治疗术后呼吸衰竭的临床效果  

Clinical observation of rhGH to treat post-operative respiratory failure

作　　者：安小虎[1] 张磊[2] 朱颖霞[2] 

机构地区：[1]中福会国际和平妇幼保健院麻醉科,上海200030 [2]同济大学附属同济医院ICU,上海200065

出　　处：《同济大学学报（医学版）》2008年第2期62-64,68,共4页Journal of Tongji University(Medical Science)

摘　　要：目的探讨重组人生长激素(recombinant human growth hormone,rhGH)对外科重大手术后患者呼吸衰竭治疗的影响。方法外科重大手术后转入重症监护病房(ICU)治疗,未能按预期停止呼吸机辅助治疗的患者28例,随机被分为治疗组和对照组,各14例,治疗组予rhGH4 IU,每日两次肌肉注射,连续治疗7 d;对照组为同期接受ICU治疗,未使用rhGH治疗的患者,两组患者的其他治疗相同。记录两组患者治疗开始后呼吸机辅助治疗的时间,第7天时患者血清白蛋白含量,血糖含量和日均胰岛素使用量,患者呼吸功能的恢复情况及在ICU的病死率。结果rhGH治疗组共12例患者停用呼吸机,2例死亡,ICU病死率14.3%;对照组共9例患者停用呼吸机,5例死亡,病死率35.7%;两组病死率比较,差异有显著性(P<0.01)。治疗前两组患者血清白蛋白浓度差异无显著性,对照组为(31.77±4.61)g.L-1,rhGH组为(31.34±4.26)g.L-1;治疗7 d后对照组为(31.12±3.71)g.L-1,rhGH组(34.17±4.16)g.L-1,差异有显著性(P<0.01)。治疗前两组患者血糖均高于正常,但两组比较差异无显著性(P>0.05),治疗后对照组较治疗前差异无显著性(P>0.05),rhGH组治疗后血糖明显高于治疗前(P<0.05),胰岛素的每日用量也明显高于治疗前(P<0.01)。结论rhGH用于重大手术后呼吸衰竭的治疗,可明显减少患者呼吸机治疗的时间,减少患者在ICU的病死率,但治疗期间应加强血糖的监测,适当增加胰岛素的用量,防止糖代谢紊乱的发生。Objective To study the effects of recombinant human growth hormone （rhGH） on the treatment of patients who have respiratory failure after big surgical operations. Methods Twenty-eight patients admitted to ICU after big surgical operations and couldn＇ t stop mechanical ventilation as expected were randomly divided into two groups （n = 14 each）. Patients in rhGH group were given rhGH 4IU twice a day for seven days continuously by intramuscular injection. Patients in control group were admitted to ICU at the same time but not given rhGH. Other treatments were same in two groups. The period of mechanical ventilation, the contents of serum albumin and blood glucose at the seventh day, the dosage of insulin per day, the recovery of respiratory function and the fatality in ICU were recorded from the beginning of the treatment. Re-suits There were twelve patients stopped mechanical ventilation and two died in rhGH group, the fatality in ICU was 14.3%. There were nine patients stopped mechanical ventilation and five died in the control group, the fatality in ICU was 35.7%. The fatality had obvious difference （ P 〈 0.01 ）. There was no significant difference in serum albumin concentration before treatment between two groups, the control group being （31.77 ±4.61 ）g · L^-1 and the rhGH group being （31.34 ± 4.26 ）g · L^-1. But significant difference in serum albumin concentration appeared after 7-days＇ treatment,the control group being （31.12± 3.71 ） and the rhGH group being（ 34.17 ± 4.16 ） g · L^ -1 （ p 〈 0.01 ）. The blood glucose of two groups Were both higher than normal, but there was no significant difference between these two groups （ P 〉 0.05 ）. Although the blood glucose after treatment had no difference compared that before treatment（P 〉0.05） ,the blood glucose of rhGH group was much higher after treatment than before treatment （ P 〈 0.05 ） and the dosage of insulin per day needed was much more than before treatment（ P 〈 0.01 ）. Conclusion rhGH is

关 键 词：重组人生长激素 外科手术 呼吸衰竭 治疗 

分 类 号：R56[医药卫生—呼吸系统]