机械通气联合夜间鼻饲阿托伐他汀治疗急性呼吸窘迫综合征的效果评价
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摘要
目的探究机械通气联合夜间鼻饲阿托伐他汀治疗急性呼吸窘迫综合征的临床治疗效果。方法选取2015年6月至2017年11月本院ICU收治的急性呼吸窘迫综合征患者59例,根据治疗方法不同分为对照组29例和观察组30例。对照组采用常规机械通气治疗,观察组采用机械通气联合夜间鼻饲阿托伐他汀治疗,对比两组患者治疗前后的血气指标、炎性细胞因子水平、机械通气时间、ICU住院时间及APACHEⅡ评分。结果观察组治疗后的PaO2和SaO2明显高于对照组,PaCO2、CRP、TNF-α、IL-6、机械通气时间、ICU住院时间及APACHEⅡ评分明显低于对照组,差异有统计学意义(P<0.05)。结论机械通气联合夜间鼻饲阿托伐他汀治疗ICU急性呼吸窘迫综合征的临床治疗效果确切,患者的血气指标和炎性细胞因子水平明显改善,机械通气时间和ICU住院时间明显缩短,APACHEⅡ评分明显降低,值得推广应用。
Objective To explore the clinical therapeutic effect of mechanical ventilation combined with nocturnal nasal feeding atorvastatin in the treatment of acute respiratory distress syndrome.Methods Fifty-nine patients with acute respiratory distress syndrome who were treated in ICU of our hospital from June 2015 to November 2017 were selected and divided into the control group(n=29)and the observation group(n=30).The patients in the control group were given conventional mechanical ventilation therapy,and the patients in the observation group were given mechanical ventilation combined with nocturnal nasal feeding atorvastatin treatment.The blood gas parameters,inflammatory cytokine levels,mechanical ventilation time,ICU hospitalization time and APACHE II scores were comparatively analyzed between the two groups before and after treatment.Results The PaO2,SaO2 of the observation group after treatment were significantly higher than those of the control group.The PaCO2,CRP,TNF-α,IL-6,mechanical ventilation time,ICU hospitalization time and APACHE II score in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Mechanical ventilation combined with nocturnal nasal feeding atorvastatin has a clear clinical effect in patients with acute respiratory distress syndrome.The patient's blood gas index and inflammatory cytokine levels are significantly improved,the mechanical ventilation time and ICU hospitalization time are significantly shortened,and the APACHE II score is significantly reduced,which is worthy of promotion.
Objective To explore the clinical therapeutic effect of mechanical ventilation combined with nocturnal nasal feeding atorvastatin in the treatment of acute respiratory distress syndrome.Methods Fifty-nine patients with acute respiratory distress syndrome who were treated in ICU of our hospital from June 2015 to November 2017 were selected and divided into the control group(n=29)and the observation group(n=30).The patients in the control group were given conventional mechanical ventilation therapy,and the patients in the observation group were given mechanical ventilation combined with nocturnal nasal feeding atorvastatin treatment.The blood gas parameters,inflammatory cytokine levels,mechanical ventilation time,ICU hospitalization time and APACHE II scores were comparatively analyzed between the two groups before and after treatment.Results The PaO2,SaO2 of the observation group after treatment were significantly higher than those of the control group.The PaCO2,CRP,TNF-α,IL-6,mechanical ventilation time,ICU hospitalization time and APACHE II score in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Mechanical ventilation combined with nocturnal nasal feeding atorvastatin has a clear clinical effect in patients with acute respiratory distress syndrome.The patient's blood gas index and inflammatory cytokine levels are significantly improved,the mechanical ventilation time and ICU hospitalization time are significantly shortened,and the APACHE II score is significantly reduced,which is worthy of promotion.
引文
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[13]陈明祺,鲁俊,陈秋华,等.他汀类药物治疗ALI/ARDS的系统回顾和Meta分析:基于国际数据库的结果[J].中华危重病急救医学,2017,29(1):51-56.
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[2]Przybysz TM,Heffner AC.Early treatment of severe acute respiratory distress syndrome[J].Emerg Med Clin North Am,2016,34(1):1-14.
[3]仇晟,王关菊,焦玉丁,等.重症急性呼吸窘迫综合征临床转归的预测因素分析[J].解放军医学杂志,2018,43(2):166-171.
[4]李松桃,方明亮,胡玲,等.他汀类药物对治疗ALI/ARDS疗效的meta分析[J].国际呼吸杂志,2018,38(1):47-52.
[5]杨艺.急性呼吸窘迫综合征的药物治疗进展[J].川北医学院学报,2016,31(3):443-446.
[6]樊冀闽.气管插管后采取序贯无创通气对急性呼吸窘迫综合征患者的干预效果[J].转化医学电子杂志,2015,2(9):27-28.
[7]张利鹏,刘国娟,周丽华.急性呼吸窘迫综合征药物治疗的最新进展[J].中华危重病急救医学,2015,27(10):862-864.
[8]常明,卢红艳,相虹,等.不同机械通气方式联合肺表面活性剂对新生儿急性呼吸窘迫综合征呼吸力学的影响[J].实用医学杂志,2017,33(6):916-919.
[9]Soran H,Schofield JD,Durrington PN.Cholesterol,not just cardiovascular risk,is important in deciding who should receive statin treatment[J].Eur Heart J,2015,36(43):2975-2983.
[10]吴永强,赵景成,杨坤,等.无创呼吸机联合乌司他丁对急性呼吸窘迫综合征患者免疫及肝肾功能的影响[J].河北医药,2016,38(9):1327-1329.
[11]李纯,毛秋瑾,汪慧,等.中重度急性呼吸窘迫综合征患者俯卧位通气的呼吸道管理[J].护士进修杂志,2017,32(19):1801-1803.
[12]Dinglas VD,Hopkins RO,Wozniak AW,et al.One-year outcomes of rosuvastatin versus placebo in sepsis associated acute respiratory distress syndrome:prospective follow up of SAILS randomised trial[J].Thorax,2016,71(5):401-410.
[13]陈明祺,鲁俊,陈秋华,等.他汀类药物治疗ALI/ARDS的系统回顾和Meta分析:基于国际数据库的结果[J].中华危重病急救医学,2017,29(1):51-56.
[14]Deshpande A,Pasupuleti V,Rothberg MB.Statin therapy and mortality from sepsis:a meta-analysis of randomized trials[J].Am J Med,2015,128(4):410-417.
[15]邱合信,邢疆波,李东风,等.不同体位机械通气对ARDS患者呼吸参数指标、血液流动学和胸部CT影像学的影响[J].中国CT和MRI杂志,2018,16(8):61-63,89.