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目的:观察参附注射液对创伤性休克患者血管外肺水(EVLW)的影响,以探讨其对创伤后毛细血管渗漏综合征(CLS)的防治作用。方法:将创伤性休克患者30例,随机分为2组,对照组16例采用西医常规治疗,治疗组14例在对照组治疗的基础上,于休克早期至损伤控制性手术后予参附注射液进行干预,共5天。观察2组患者血管外肺水指数(EVLWI)变化;CLS发病率、病死率;ICU入住时间。结果:术后第2天,2组EVLWI有升高趋势,且对照组EVLWI较术后第1天显著升高(P<0.05)。术后第3、4、5天,治疗组EVLWI呈下降趋势,与本组术后第1天及对照组同时间比较,差异均有统计学意义(P<0.05)。对照组至术后第5天,EVLWI较术后第1天显著下降(P<0.05)。治疗组死亡率、入住ICU时间均少于对照组,差异均有统计学意义(P<0.05)。2组诊断为CLS病例数则相当,差异无统计学意义(P>0.05)。结论:参附注射液可降低创伤性休克患者血管外肺水,减轻肺毛细血管渗漏程度,降低创伤后CLS患者的病死率,缩短ICU的入住时间。
Objective: To observe the effect of Shenfu injection on extravascular lung water (EVLW) in patients with traumatic shock and to explore its preventive and therapeutic effects on post-traumatic capillary leak syndrome (CLS). Methods: Thirty patients with traumatic shock were randomly divided into two groups. Sixteen patients in the control group were treated routinely with Western medicine. In the treatment group, 14 patients were treated with the control group, Liquid intervention, a total of 5 days. The changes of extravascular lung water index (EVLWI) in 2 groups were observed. The incidence of CLS, mortality and ICU admission time were observed. Results: On the second postoperative day, the EVLWI in both groups had an increasing trend, and the EVLWI in the control group was significantly higher than that on the first postoperative day (P <0.05). On the 3rd, 4th and 5th days after operation, the EVLWI of the treatment group showed a decreasing trend, which was significantly different from that of the first day and the control group (P <0.05). In the control group, EVLWI decreased significantly (P <0.05) on the fifth day after operation compared with the first day after operation. The treatment group mortality, ICU admission time were less than the control group, the difference was statistically significant (P <0.05). The number of cases diagnosed as CLS was similar in the two groups, with no significant difference (P> 0.05). Conclusion: Shenfu injection can reduce extravascular pulmonary water in patients with traumatic shock, reduce pulmonary capillary leakage, reduce mortality after trauma CLS patients, and shorten the ICU stay.