短程大剂量山莨菪碱联用地塞米松治疗危重型多发伤患者效果观察  

Effect of combined short-range high dosage anisodamine with dexamethasone in the treatment of severe multiple trauma patients

作　　者：陈正钢[1] CHEN Zheng-gang(Department of Emergency, Suzhou Kowloon Hospital Affiliated Shanghai Jiao Tong University School of Medicine, Suzhou215000,Jiangsu, China)

机构地区：[1]上海交通大学医学院附属苏州九龙医院急诊科,苏州215000

出　　处：《中国临床医学》2016年第6期820-822,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:探讨短程大剂量山莨菪碱联用地塞米松治疗危重型多发伤患者的临床效果,并阐述作用机制。方法:临床纳入危重型多发伤患者70例,根据随机数字表法分为研究组与对照组。研究组给予山莨菪碱联合地塞米松,对照组给予门冬氨酸钾镁联合地塞米松。观察两组患者临床疗效,同时对比治疗前后两组患者肿瘤坏死因子(tumor necrosis factor,TNF)、脂质过氧化物(lipid hydroperoxide,LPO)水平。此外,观察两组患者治疗前后肝肾功能等安全性指标的变化。结果:研究组病死率为11.43%,对照组病死率为22.86%,差异有统计学意义(P<0.05);但治疗后,研究组血TNF、LPO水平分别为(77.02±12.77)μmol/L、(2.94±0.72)μmol/L,而对照组血TNF、LPO水平分别为(112.46±15.91)μmol/L、(5.03±1.03)μmol/L,差异均有统计学意义(P<0.05);治疗前后,两组患者肝肾功能等指标水平差异均无明显变化,差异无统计学意义。结论:短程大剂量山莨菪碱联用地塞米松能够显著降低危重型多发伤患者的死亡率,且应用安全可靠,其作用机制可能在于抑制机体TNF、LPO水平。Objective ： To investigate the clinical effect of combined short-range high dosage Anisodamine withDexamethasone in the treatment of severe multiple trauma patients and to state the mechanism. Methods： Totally 70 patients withsevere multiple trauma were selected and divided into study group and control group according to random number table method Theresearch group was treated with Anisodamine combined with Dexamethasone, and the control group was given potassium magnesiumaspartate combined with Dexamethasone, The clinical efficacy of the two groups was observed, and the levels of tumor necrosis factor（TN F） and lipid hydroperoxide （LPO） were compared between the two groups before and after treatment. In addition, the changes ofliver and kidney function in the two groups were observed before and after treatment. Results： The fatality rate of the study group was11. 43% , and the control group was 22. 86% , and the difference was statistically significant （P〈C〇. 05）. After treatment, the TN F,LPO levels were （77. 02± 12. 77） mol/L and （2. 94 ± 0. 72） mol/L respectively in study group while （112. 46 ± 15. 91） jumol/L and（5. 03± 1. 03） jitmol/L respectively in control group, and the differences were statistically significant （P〈C〇. 05）. Before and aftertreatment, there was no significant difference in the levels of liver and kidney function between the two groups and the difference wasnot statistically significant （ P 〉 0 . 05）. Conclusions： The combined short-range high dosage Anisodamine with Dexamethasone cansignificantly reduce the fatality rate of severe multiple trauma patients with safe and reliable application and its mechanism is likely toinhibit the level of LPO and TNF.

关 键 词：山莨菪碱 地塞米松 危重型多发伤 疗效 安全性 

分 类 号：R641[医药卫生—外科学]