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      東茛菪堿與地塞米松聯(lián)合治療在急性中毒性肺水腫搶救中的臨床分析

      2020-05-25 02:44:05王華德,桑運(yùn)春
      中外醫(yī)療 2020年4期
      關(guān)鍵詞:肺水腫通氣實(shí)驗(yàn)組

      王華德,桑運(yùn)春

      [摘要] 目的 觀察東茛菪堿與地塞米松聯(lián)合治療在急性中毒性肺水腫搶救中的臨床分析。方法 方便選取該院2016年1月—2018年12月期間收治的急性中毒性肺水腫患者行常規(guī)治療配合東茛菪堿與地塞米松聯(lián)合搶救總計(jì)80例,隨機(jī)分為觀察組和對(duì)照組。通過(guò)觀察兩組患者治療時(shí)治療起效時(shí)間、水腫消失時(shí)間、治療前后血?dú)庵笜?biāo)水平與住院時(shí)間,治療效果與預(yù)后。結(jié)果 經(jīng)治后實(shí)驗(yàn)組患者血?dú)庵笜?biāo)水平明顯優(yōu)于對(duì)照組,而實(shí)驗(yàn)組患者治療起效時(shí)間、水腫消失時(shí)間與住院時(shí)間明顯少于對(duì)照組,實(shí)驗(yàn)組與對(duì)照組患者治愈率(92.5% vs 55.0%),反跳率(2.5% vs 15.0%),轉(zhuǎn)院率(5.0% vs 20.0%),死亡率(0.0% vs 10.0%),差異有統(tǒng)計(jì)學(xué)意義(t=9.752, P=0.000; t=7.607, P=0.000,t=0.246, P=0.807; t=5.342, P=0.000; t=0.123, P=0.919;t=7.843, P=0.000;t=8.630, P=0.000;χ2=13.341, P=0.000; χ2=3.914, P=0.048; χ2=4.114, P=0.043; χ2=4.211, P=0.041)。 結(jié)論 在急性中毒性肺水腫患者的搶救中,采取東茛菪堿與地塞米松聯(lián)合治療,可明顯縮短患者治療起效時(shí)間與水腫消失時(shí)間,提高臨床救治效果。

      [關(guān)鍵詞] 東茛菪堿;地塞米松;聯(lián)合治療;急性中毒性肺水腫;搶救效果

      [中圖分類(lèi)號(hào)] R595 ? ? ? ? ?[文獻(xiàn)標(biāo)識(shí)碼] A ? ? ? ? ?[文章編號(hào)] 1674-0742(2020)02(a)-0112-03

      Clinical Analysis of Combined Treatment of Scopolamine and Dexame thasone in Acute Toxic Pulmonary Edema

      WANG Hua-de, SANG Yun-chun

      Department of General Surgery, Feixian People's Hospital, Linyi, Shandong Province, 273400 ?China

      [Abstract] Objective To observe the clinical analysis of the combined treatment of scopolamine and dexamethasone in the rescue of acute toxic pulmonary edema. Methods Convenient selection of 80 patients who were admitted to the hospital recently from January 2016 to December 2018 for diagnosis of acute toxic pulmonary edema and received conventional treatment in combination with east hyosamine and dexamethasone were randomly divided into the observation group and the control group. By observing the treatment onset time, edema disappearance time, blood gas index level and hospital stay before and after treatment, the treatment effect and prognosis of the two groups of patients. Results After treatment group was better than control group, patients with blood gas index level and effect of the experimental group patients, edema disappeared time and hospitalization time significantly less than the control group, experimental group and control group cure rate (92.5% vs 55.0%) patients, bounce rate (2.5% vs 15.0%), transfer rate(5.0% vs 20.0%), mortality (0.0% vs 10.0%), statistically significant difference (t=9.752, P=0.000; t=7.607, P=0.000,t=0.246, P=0.807; t=5.342, P=0.000; t=0.123, P=0.919;t=7.843, P=0.000;t=8.630, P=0.000;χ2=13.341, P=0.000; χ2=3.914, P=0.048; χ2=4.114, P=0.043; χ2=4.211, P=0.041). Conclusion In the rescue of patients with acute toxic pulmonary edema, the combination of scopolamine and dexamethasone can significantly shorten the onset time of treatment and the disappearance time of edema, and improve the clinical treatment effect.

      該研究中,經(jīng)治后實(shí)驗(yàn)組患者血?dú)庵笜?biāo)水平明顯優(yōu)于對(duì)照組,而實(shí)驗(yàn)組患者治療起效時(shí)間、水腫消失時(shí)間與住院時(shí)間明顯少于對(duì)照組,實(shí)驗(yàn)組與對(duì)照組患者治愈率(92.5% vs 55.0%),反跳率(2.5% vs 15.0%),轉(zhuǎn)院率(5.0% vs 20.0%),死亡率(0.0% vs 10.0%),差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。

      綜上所述,在急性中毒性肺水腫患者的搶救中,采取東茛菪堿與地塞米松聯(lián)合治療,可明顯縮短患者治療起效時(shí)間與水腫消失時(shí)間,提高臨床救治效果,改善患者血?dú)庵笜?biāo)及預(yù)后,并縮短住院時(shí)間,間接減輕患者及家屬經(jīng)濟(jì)負(fù)擔(dān),效果理想。

      [參考文獻(xiàn)]

      [1] ?丁毅. 托拉塞米注射液聯(lián)合機(jī)械通氣+PEEP 治療重癥急性肺水腫療效分析[J].中國(guó)急救醫(yī)學(xué),2016,36(1):234- 235.

      [2] ?Ewa WS,Wierszcz Jolanta,Andrzej S.Effects of Atorvastatin Dose and Concomitant Use of Angiotensin-Converting Enzyme Inhibitors on Renal Function Changes over Time in Patients with Stable Coronary Artery Disease: A Prospective Observational Study[J].International Journal of Molecular Scien ces,2016,17 (2): 106-109 .

      [3] ?徐剛, 董芳, 董碧華,等. 機(jī)械通氣治療急性心肌梗死合并急性肺水腫的臨床效果[J].實(shí)用臨床醫(yī)藥雜志, 2016, 20(3):7-10.

      [4] ?Bao -Jia LI,Quan MO,Shi GJ,et al. Study on the application value of percutaneous dilational tracheostomy on the rescue of patients with severe cerebrovascular accident[J].China Modern Medicine,2016(21):50-53.

      [5] ?孟瑤. 急性心肌梗死合并急性肺水腫應(yīng)用機(jī)械通氣輔助治療的效果觀察[J].中國(guó)煤炭工業(yè)醫(yī)學(xué)雜志,2015,18 (10):1639-1642.

      [6] ?羅曉紅,郭文靜,許瑞元,等.模擬不同海拔低氧對(duì)大鼠下丘腦-垂體-甲狀腺軸及肺組織 VEGF和 HIF-1表達(dá)的影響[J].解放軍醫(yī)學(xué)院學(xué)報(bào),2016,37(8):864-868.

      [7] ?申強(qiáng), 吳鐵軍, 王國(guó)青. 機(jī)械通氣治療急性心肌梗死并急性肺水腫的臨床效果觀察[J].實(shí)用心腦肺血管病雜志, 2016, 22(8):147-148.

      [8] ?陸啟光.參附注射液聯(lián)合有創(chuàng)機(jī)械通氣治療急性心源性肺水腫的臨床效果分析[J].中華中醫(yī)藥學(xué)刊,2015,17(6):1533-1536.

      [9] ?蒙萍,王寧,漆欣柱,等.模擬海拔8 000m 高原缺氧環(huán)境對(duì)大鼠腦組織線(xiàn)粒體自噬的影響[J].解放軍醫(yī)藥雜志,2016, 28(6):9-13.

      [10] ?季一娟, 單紅衛(wèi), 巢益群,等. 有創(chuàng)-無(wú)創(chuàng)序貫機(jī)械通氣對(duì)急性心源性肺水腫患者低氧血癥和血流動(dòng)力學(xué)的影響[J]. 現(xiàn)代生物醫(yī)學(xué)進(jìn)展, 2016, 16(29):5651-5654.

      (收稿日期:2019-11-04)

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