论文部分内容阅读
目的 :探索高原地区胸部手术后急性肺损伤的发病趋势和早期防治效果。方法 :选择拟行食管癌切除术 36例 ,随机分为对照组 (CG ,n =2 0 )和防治组 (TG ,n =16 )。CG术前常规处理 ,TG加服复方红景天 (RCO ,3.2g·d 1) ,平均 ( 8.5± 1.3)d。两组均进行术前、后动脉血气、生化全项等 33项多脏器功能指标检查 ,比较两组指标参数的变化。结果 :术前两组PaO2 /FiO2 均介于 2 80～ 370mmHg之间 ,两组相比P >0 .0 5。术后第 1、3、5天CGPaO2 /FiO2 依次为 15 1.97,16 2 .6 2 ,2 0 8.90mmHg ,TGPaO2 /FiO2依次为 16 2 .38,182 .4 5 ,2 5 1.36mmHg,与术前相比均P <0 .0 1;术后第 5天CG与TGAaDO2 相比有显著差异 (P <0 .0 5 )。术后所有病人均可诱发SIRS、ALI,大部可达到ARDS的血气标准。CG术后合并ARDS1例治愈 ,MODS1例术后第 10天死亡 ,全组死亡率为 2 .8%。结论 :目前通用的国内外ARDS/MODS诊断标准不适用于中度高原以上地区 ;早期应用RCO对预防胸部手术后急性肺损伤效果显著。
Objective: To explore the trend and early prevention and treatment of acute lung injury following thoracic surgery in the plateau. Methods: 36 cases of esophageal resection were selected and randomly divided into control group (CG, n = 20) and control group (TG, n = 16). CG conventional preoperative treatment, TG plus compound Rhodiola (RCO, 3.2g · d 1), an average of (8.5 ± 1.3) d. In both groups, 33 items of multiple organ function indexes such as preoperative and postoperative arterial blood gas and biochemical items were examined, and the changes of index parameters were compared between the two groups. Results: The preoperative PaO2 / FiO2 values ranged from 280 to 370 mmHg in both groups, P> 0.05. The values of CGPaO2 / FiO2 on the 1st, 3rd and 5th day after operation were 15 1.97, 16 2 .6 2 and 20 8.90 mmHg, respectively, and the TGPaO2 / FiO2 were 16 2 .38,182.45 and 2 5 1.36 mmHg, (P <0.01). There was a significant difference between CG and TGAaDO2 on the 5th postoperative day (P <0.05). All patients can be induced after surgery SIRS, ALI, most of the gas can reach ARDS standards. The patients with CG complicated with ARDS were cured. The MODS1 patients died on the 10th day after operation, and the whole group mortality was 2.8%. Conclusion: The current domestic and international ARDS / MODS diagnostic criteria do not apply to moderate altitude over the area; early application of RCO on the prevention of acute lung injury after chest surgery has a significant effect.