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选择10例危重细菌性肺炎伴低氧性呼衰患者,口服或直肠给以消炎痛1mg/kg,其后1和2小时测动脉和静脉的PO_2、PCO_2和pH.并测心率、血压、平均肺动脉压和楔压等.以观察消炎痛对其动脉氧合作用的影响.结果消炎痛可以明显地增加PaO_2和PaO_2/F_1O_2的比值并降低A-aPO_2,而气体交换或血液动力学参数均无明显地变化.5例PaO_2明显升高(27～42mmHg),3例轻度升高(7～9 mmHg),2例无改变.对明显升高的2例进一步研究表明,在PaO_2降至基础值4～6小时后,再给消炎痛PaO_2又显著地增加(例1由72升至99,例2由54升至128mmHg)。例1在PaO_2升高的同时伴随肺内分流的降低(由45%降至30%),另2例置肺动脉导管的患者应用消炎痛后肺内分流降低甚微,PaO_2的变化也很少.急性细菌性肺炎时引起的低氧血症主要是因充满
Ten patients with severe bacterial pneumonia and hypoxemic respiratory failure were enrolled in this study. Indomethacin (1 mg / kg) was given orally or rectally, then PO_2, PCO_2 and pH of arteries and veins were measured 1 and 2 hours later. Heart rate, blood pressure, mean Pulmonary arterial pressure and wedge pressure etc. To observe the effect of indomethacin on arterial oxygenation.Results Indomethacin significantly increased the PaO 2 and PaO 2 / F 1 O 2 ratios and decreased A-aPO 2, while none of the gas exchange or hemodynamic parameters (P <0.05) .5 cases of PaO_2 increased significantly (27 ~ 42mmHg), 3 cases of mild increase (7 ~ 9 mmHg), 2 cases did not change.A significant increase in 2 cases further study showed that PaO_2 dropped to the foundation After 4 to 6 hours, PaO 2 was given a significant increase in indomethacin (Example 1 from 72 to 99, Example 2 from 54 to 128 mmHg). Example 1 PaO2 decreased concomitantly with decreased pulmonary shunt (45% to 30%). In the other two patients with pulmonary artery catheter indomethacin, indomethacin decreased slightly in the shunt of the lung and little changed in PaO_2. Acute bacterial pneumonia caused by hypoxemia is mainly due to full