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目的研究沐舒坦静脉滴注和静脉待续泵入对急性呼吸窘迫综合征(ARDS)患者综合救治的影响。方法选择ARDS 患者63例,随机分成对照组(A 组20例)和观察组(B 组21例;C 组22例)。3组病人在相同综合救治的基础上 A 组应用生理盐水200ml,B 组应用沐舒坦60mg 加生理盐水200ml 静脉滴注,C 组应用沐舒坦60mg 加生理盐水200ml 静脉持续泵入/24h 连续7d。观察3组病人治疗前后血液中的 IL-6、IL-8浓度,动脉血气分析,肺损伤程度的变化。比较上述指标在治疗前后组内及3组之间的差异,结果 C 组治疗后.病人血液中 IL-6,IL-8浓度,动脉血气分析,肺损伤程度评分较治疗前、B 组和对照组均明显改善(P<0.05或 P<0.01);B 组治疗后,病人血液中 IL-6、IL-8浓度在7d 后较治疗前和对照组均明显降低(P<0.05),动脉血气分析,肺损伤程度评分较治疗前、对照组均明显改善(P<0.05或 P<0.01);而对照组虽然动脉血气有明显改善(P<0 05),但该组病人血清炎症介质浓度和肺损伤程度评分则改变不明显(P>0.05)。结论沐舒坦能在一定程度上抑制炎症介质的释放,减轻急性肺损伤,有利于 ARDS 患者呼吸功能的恢复;静脉持续泵入比静脉滴注效果更好。
Objective To study the effects of intravenous mucosolvan infusion and intravenous infusion on the comprehensive treatment of patients with acute respiratory distress syndrome (ARDS). Methods Sixty-three ARDS patients were randomly divided into control group (20 cases in group A) and observation group (21 cases in group B and 22 cases in group C). Three groups of patients on the basis of the same comprehensive treatment of A group with saline 200ml, B group with mucosolvan 60mg plus saline 200ml intravenous infusion, C group with mucosolvan 60mg plus saline 200ml continuous infusion / 24h continuous 7d. The levels of IL-6, IL-8 in blood, arterial blood gas analysis and lung injury were observed before and after treatment in 3 groups of patients. The above indexes were compared between the groups before and after treatment and the differences among the three groups. Results After treatment, the blood levels of IL-6, IL-8, arterial blood gas analysis and lung injury in group C were significantly higher than those before treatment, group B and control (P <0.05 or P <0.01). After treatment, the concentration of IL-6 and IL-8 in the blood of the patients in the B group were significantly lower than those before the treatment and in the control group after 7 days (P <0.05) (P <0.05 or P <0.01), while the control group, although the arterial blood gas was significantly improved (P <0 05), but the group of patients with serum inflammatory mediators concentration and The score of lung injury did not change significantly (P> 0.05). Conclusion Mucosolvan can inhibit the release of inflammatory mediators to a certain extent, reduce acute lung injury, which is beneficial to the recovery of respiratory function in patients with ARDS. Continuous intravenous infusion is better than intravenous infusion.