重组人生长激素在老年患者胸腹部术后急性呼吸衰竭机械通气治疗中的作用  

Effect of recombinant human growth hormone on mechanical ventilation in treatment of acute respiratory failure in elderly patients after thoracic and abdominal operation

作　　者：盛春风[1] 方志成[1] 刘伯毅[1] 方敏[1] 刘培[1] 郑翔[1] 

机构地区：[1]湖北医药学院附属太和医院,十堰442000

出　　处：《内科急危重症杂志》2012年第3期148-150,共3页Journal of Critical Care In Internal Medicine

基　　金：十堰市科技攻关项目(No:2009045D)

摘　　要：目的:探讨重组人生长激素(rhGH)在老年患者胸腹部术后急性呼吸衰竭机械通气治疗中的作用及合适剂量。方法:将45例老年胸腹部术后急性呼吸衰竭(ARF)患者随机分为3组,每组15例,A治疗组采用rhGH4IU,肌肉注射,1次/d,连续治疗10d;B治疗组采用rhGH4IU,肌肉注射,2次/d,连续治疗10d;对照组未用rhGH治疗。3组其他治疗相同。观察3组治疗后的机械通气时间、一次拔管成功率、呼吸机相关肺炎(VAP)发生率、平均住ICU时间、ICU病死率及第10d患者血糖含量、每日胰岛素用量。结果:A、B治疗组与对照组相比,在机械通气时间、平均住ICU时间明显缩短(P<0.05);一次拔管成功率、VAP发生率、ICU病死率优于对照组(P<0.05)。治疗前3组患者血糖均高于正常,但差异无显著性(P>0.05),rhGH治疗后血糖较治疗前均有升高,其中B组较对照组差异有统计学意义(P<0.05)。rhGH治疗后胰岛素的每日用量均明显高于治疗前(P<0.05),但在可控范围内。结论:rhGH在每日4IU治疗10d用于老年患者胸腹部术后ARF是安全有效的,但治疗期间应加强血糖的监测,强化胰岛素治疗,防止糖代谢紊乱的发生。Objective：To explore the effect and the ideal dose of recombinant human growth hormone （rhGH） on mechanical ventilation in treatment of acute respiratory failure （ARF） in elderly patients after thoracic and abdominal operations. Methods：Forty-five elderly patients with ARF after thoracic and abdominal operation were randomly divided into 3 groups ,15 cases for each group. Patients in group A were given rhGH 41U once a day for 10 days by intramuscular injection. Patients in group B were given rhGH 4IU twice a day for 10 days by intramuscular injection. Patients in the control group were not given rhGH. Other treatments were the same in 3 groups. Time of mechanical ventilation, the suc- cess rate of withdrawing intubation at one time, the incidence of ventilator-associated pneumonia （VAP）, average stay and mortality in ICU, the level of blood glucose and the dosage of insulin per day and at the 10th day were observed after treatments. Results：The time of mechanical ventilation and average stay in ICU were shorter significantly in group A and B（ P 〈 0.05 ）, and the success rate of one time withdrawing intubation, VAP and ICU mortality were also superior to those of control group（ P 〈 O. 05 ）. There was no significant difference on the level of blood glucose which was higher than normal before treatment in 3 groups （ P 〉 0.05 ） , but the level of blood glucose was slightly elevated after treatment of rhGH, whereas group B shows statistical difference when compared with that of control group （ P 〈 0.05 ）. The dosage of insulin per day needed was much more than before the treatment of rhGH（ P 〈 O. 05 ） , but it was in the controllable range. Conclusions ：The rhGH with a dose of 4IU daily for 10 days is safe for the elderly patients with ARF after thoracic and abdominal operation, but the level of blood glucose monitoring and rational insulin therapy should be strengthened in order to prevent disturbance of glycometabolism.

关 键 词：呼吸功能不全 机械通气 重组人生长激素 老年人 

分 类 号：R563.8[医药卫生—呼吸系统]