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目的:观察鱼油脂肪乳治疗脑外伤后全身炎症反应综合征(SIRS)的临床疗效,并探讨其可能机制。方法:将148例脑外伤后并发SIRS病人随机分为治疗组和对照组,每组74例。两组除给予常规临床处理外,治疗组给予20%脂肪乳250 ml+鱼油脂肪乳10 g静脉滴注;对照组给予20%脂肪乳250 ml,1次/d,共10 d。观察两组病人治疗前后急性生理学和慢性健康状况评分(APACHEⅡ)、多器官功能障碍综合征(MODS)发生率和病死率,并测定治疗前后血C-反应蛋白(CRP)水平。结果:治疗后两组病人APACHEⅡ评分明显降低。两组MODS发生率和病死率均有显著差异(P<0.05)。鱼油脂肪乳治疗组病人CRP浓度明显低于对照组(P<0.01)。结论:鱼油脂肪乳治疗脑外伤后SIRS的临床疗效显著,对稳定病人早期生命体征和降低脑外伤病死率的作用较好。
Objective: To observe the clinical efficacy of fish oil fat emulsion in the treatment of systemic inflammatory response syndrome (SIRS) after traumatic brain injury and to explore its possible mechanism. Methods: 148 patients with SIRS after traumatic brain injury were randomly divided into treatment group and control group, 74 cases in each group. In addition to routine clinical treatment, the treatment group was given 20% fat emulsion 250 ml + fish oil emulsion 10 g intravenously; the control group was given 20% fat emulsion 250 ml once a day for 10 days. Acute physiology and chronic health status score (APACHEⅡ), multiple organ dysfunction syndrome (MODS) incidence and mortality were observed before and after treatment. The level of CRP was measured before and after treatment. Results: After treatment, APACHE Ⅱ scores of two groups were significantly lower. Two groups of MODS incidence and mortality were significantly different (P <0.05). The concentration of CRP in fish oil emulsion treated group was significantly lower than that in control group (P <0.01). Conclusion: The therapeutic effect of fish oil fat emulsion on SIRS after traumatic brain injury is significant, which has a good effect on stabilizing patients’ early vital signs and reducing the mortality rate of traumatic brain injury.