脂微球-前列腺素E1治疗急性呼吸窘迫综合征的临床观察  

Clinical observation of liposome-prostaglandin E1 for patients with acute respiratory distress syndrome

作　　者：侯剑锋[1] 张洪[1] 冯健[1] 

机构地区：[1]深圳市急救中心,广东深圳518035

出　　处：《中国现代医学杂志》2014年第19期59-62,共4页China Journal of Modern Medicine

摘　　要：目的观察分别接受脂微球前列腺素E1（1ipo—PGE1）和常规治疗的急性呼吸窘迫综合征（AMS）患者的动咏血气指标、氧合状况的变化，评价其治疗效果。方法对2005年1月-2010年12月该院收治的79急性呼吸窘迫综合征病人进行回顾性分析。其中，41例采用静脉应用lipo—PGEl治疗，38例进行常规治疗，lipo—PGE1治疗组在入院24h后静脉滴注lipo—PGE1 3ng／（kg·min），持续2h，每天2次，连用1-2周。记录两组治疗前后生物学标记物，并在各个指标均衡可比的基础上，应用c检验比较两组患者的血流动力学、动脉血气、呼吸机通气时间、住ICU时间，生存率比较采用）（z检验。结果lipo—PGE1治疗组和常规治疗组生存率差别具有显著性（P〈0．05），呼吸机通气时间、患者住ICU1时间差别也均有显著性（均P〈0．05）。lipo—PGE1治疗组氧分压、氧合指数（氧分压／吸氧分数）恢复比常规治疗组早（P〈0．05）。lipo～PGE1还能有效降低肺血管阻力和肺动脉压，增加心排量和氧输送量。结论lipo—PGE1治疗ARDS有疗效明确，能缩短住ICU时间，降低患者病死率和医疗费用。[ Objective ] To observe the blood gas and oxygenation changes of 79 patients with acute respiratory distress syndrome （ARDS） after using liposome-prostaglandin E1 （lipo-pgE1） in and to evaluate the clinical efficacy of lipo-pgE1. [Methods] 79 cases of acute respiratory distress syndrome in our hospital from January 2005 to December 2010 were retrospectively analyzed. 41 of 79 cases accepted an intravenous bolus of lipo-PGE1 for 3 ng/ （kg·min） for 2 hours at the 24 h hour after admission, twice a day and continued for 1-2 weeks and combined conventional therapy and the others only accepted conventional therapy. The survival rates were calculated by Chi- Square analysis and hemodynamic, arterial blood pressure, duration of assisted ventilation and average stay in the intensive care （ICU） were calculated by -test. [Result] The survival rates of the conventional therapy group and the lipo-PGE1 group were significant difference （P 〈0.05）. In the two groups the duration of assisted ventilation and the average time of staying in the intensive care （ICU） were also significantly different（P 〈0.05）. The PaO2 and PaO2/FiO2 were raised in both groups, but the recovery point-in-time in the lip-PGE1 was earlier than that in the conventional therapy group, lip-PGE1 could decrease pulmonary vascular resistance and pulmonary arterial pressure but increase cardiac output and oxygen delivery. [ Conclusions ] The treatment of ARDS by lipo-PGE 1 can lower the duration of average stay in ICU and raise the survival rates.

关 键 词：急性呼吸窘迫综合征 治疗 脂微球一前列腺素E1 

分 类 号：R563.8[医药卫生—呼吸系统]