个体化治疗方案在急性呼吸窘迫综合征中应用的效果及对呼吸及循环指数、血清炎症因子的影响  

Clinical value of individualized therapy in acute respiratory distress syndrome and the effects on respiratory and circulatory index and serum inflammatory factors

作　　者：郭林[1] 聂志 郭兰[1] 许庆林[1] 刘子由[1] 鲁玉凤[1] GUO Lin;NIE Zhi;GUO Lan;XU Qing-lin;LIU Zi-you;LU Yu-feng(ICU,the First Affiliated Hospital of Gannan Medical College,Jiangxi,Gannan 341000,China)

机构地区：[1]赣南医学院第一附属医院重症医学科,江西赣南341000 [2]大余县人民医院呼吸科,江西赣南341000

出　　处：《中国卫生检验杂志》2018年第18期2248-2251,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的观察急性呼吸窘迫综合征(ARDS)个体化治疗的疗效,并评价其临床应用价值。方法选择ARDS患者80例,随机分为研究组和对照组,各40例,分别给予个体化治疗和常规治疗,比较2组的治疗情况及预后。结果研究组治疗后的心率(HR)、平均动脉压(MAP)、氧合指数(OI)及呼吸指数(RI)均较治疗前显著改善(P<0.05),其中HR、OI及RI的改善情况明显优于对照组(P<0.05);研究组治疗后的血清超敏C-反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-1β(IL-1β)水平均较治疗前显著降低(P<0.05),且均明显低于对照组治疗后(P<0.05);与对照组比,研究组的机械通气时间、ICU住院时间均较短,呼吸机相关性肺炎(VAP)发生率及病死率均较低,组间差异有统计学意义(P<0.05)。结论 ARDS个体化治疗可有效改善患者的肺氧合功能,减轻炎症,缩短机械通气时间并改善预后,临床应用价值较高。Objective To observe the efficacy of individualized therapy for acute respiratory distress syndrome（ ARDS） and to evaluate its clinical value. Methods Eighty patients with ARDS were randomly divided into study group（ n = 40） and control group（ n = 40）. Patients in the study group and the control group received individualized treatment and conventional treatment,respectively. And the general situation and prognosis of patients between the two groups were compared. Results After treatment,the heart rate（ HR）,mean arterial pressure（ MAP）,oxygenation index（ OI） and respiratory index（ RI） of patients in the study group were significantly improved（ P 〈 0. 05）,and the improvement of HR,OI and RI were significantly better than those in the control group（ P 〈 0. 05）. The levels of serum hypersensitivity C reactive protein（ hs-CRP）,tumor necrosis factor-α（ TNF-α） and interleukin-1 β（ IL-1 β） in the study group after treatment were significantly lower than those before treatment and those in the control group after treatment（ P 〈 0. 05）. Compared with the control group,the study group had shorter mechanical ventilation time and shorter ICU hospitalization time（ P 〈 0. 05）. Moreover,the incidence of ventilator associated pneumonia（ VAP） and the case fatality rate in the study group were obviously lower than those in the control group,with the differences statistically significant（ P 〈 0. 05）. Conclusion The individualized therapy for ARDS could effectively improve pulmonary oxygenation function,reduce inflammation,shorten mechanical ventilation time and improve prognosis,and it has higher clinical application value.

关 键 词：急性呼吸窘迫综合征 个体化治疗 机械通气 炎症因子 预后 

分 类 号：R563.8[医药卫生—呼吸系统]