亚低温结合呼气末正压通气治疗神经源性肺水肿的临床研究  

Efficacy of mild hypothermia combined with positive end expiratory pressure ventilation therapy in neurogenic pulmonary edema

作　　者：韩威[1] 赵爱源[2] 马红珊[3] 张璐[2] 陈镭[4] 

机构地区：[1]武警医学院训练部,天津300162 [2]武警医学院基础部,天津300162 [3]武警总医院首保科,北京100039 [4]武警医学院附属医院脑系科,天津300162

出　　处：《武警医学》2009年第9期790-793,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：天津市科委重点攻关科研基金资助项目(06YFSF01200)

摘　　要：目的研究亚低温结合呼气末正压通气治疗神经源性肺水肿(NPE)的临床意义。方法将68例脑出血致NPE患者随机分为:常规治疗组(RT组)32例、亚低温结合呼气末正压通气治疗组(HP组)36例。分别给予常规治疗、亚低温结合呼气末正压通气治疗。两组患者在发病时及治疗后7 d检测血液中丙二醛(MDA)、促肾上腺皮质激素(ACTH)及血糖水平;并进行临床神经功能缺损评分(NIHSS)以判断疗效。结果两组患者在接受各自的治疗后其MDA、ACTH、血糖以及NIHSS评分较治疗前均明显下降,差异有统计学意义(P<0.05)。在接受治疗7 d后RT组患者MDA、ACTH、血糖以及NIHSS评分高于HP组,差异有统计学意义(P<0.05)。结论亚低温结合呼气末正压通气可有效治疗NPE。Objective To investigate the curative effect of mild hypothermia combined with PEEP ventilation therapy on neurogenic pulmonary edema（NPE）. Methods Sixty -eight patients with cerebral hemorrhage and concomitant NPE were randomly divided into two groups for routine treatment （32 cases, RT group） or mild hypothermia and PEEP ventilation therapy （36 cases, HP group）. In the HP group, mild hypothermia and PEEP ventilation therapy were applied in addition to the routine treatment. The changes in serum malondialdehyde （MDA）, adrenocorticotropic hormone （ACTH）, blood glucose, and NIHSS score were observed before and 7 days after the treatment. Results There were significant decreases in MDA,ACTH, GLU, and NIHSS scores in both groups （P 〈 0. 05）. The MDA, ACTH, GLU, and NIHSS score were significantly lower in HP group than in RT group （P 〈 0. 05）. Conclusions The mild hypothermia combined with PEEP ventilation therapy has significant therapeutic effect on NPE.

关 键 词：神经源性肺水肿 亚低温 呼气末正压通气 

分 类 号：R651.15[医药卫生—外科学]