肺保护性机械通气联合还原型谷胱甘肽治疗急性肺损伤的临床观察(1)
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【摘要】 目的 评估肺保护性机械通气联合还原型谷胱甘肽治疗急性肺损伤(ALI)的临床疗效。方法 将81例ALI患者随机分为对照组和治疗组,治疗组42例，对照组39例，两组均常规积极治疗原发病的基础上进行肺保护性机械通气，治疗组在常规治疗、肺保护性机械通气的基础上联用还原型谷胱甘肽注射液，1.8 g/d,疗程5 d。对比两组治疗前后血气分析、炎症指标的变化,记录重症监护病房(ICU)住院时间、病死率及比较两组患者的治疗效果及其预后。结果 治疗组PaO2、氧合指数高于对照组,炎症指标低于对照组，差异有统计学意义(P<0.01),肺保护性通气联合还原型谷胱甘肽治疗有效率达88.1%,与对照组61.5%相比差异有统计学意义(P<0.01);还原型谷胱甘肽组住ICU时间短于对照组,死亡率低于对照组。结论 在积极治疗原发病、综合治疗基础上予肺保护性通气联合还原型谷胱甘肽治疗ALI能改善患者的呼吸功能及预后。
【关键词】
肺保护性通气; 还原型谷胱甘肽; 急性肺损伤；急性呼吸窘迫综合征
Lung protective mechanical ventilation combined reduced glutathione for the treatment of acute lung injury
ZHANG Huaru, ZHANG Yonggang, LI Haiming,et al.
Department of Respiratory Medicine,Zhumadian Municipal Central Hospital of Henan Province, Zhumadian 463000,China
【Abstract】 Objective
To investigate the effect of lung protective mechanical ventilation combined reduced glutathione for the treatment of acute lung injury(AIL).Methods The 81 cases of AIL patients were randomly divided into treatment group(n=42) and control group (n=39), Both groups were given general for lung protective mechanical ventilation.The treatment group were given 1.8 g/d intravenous reduced glutathione for 5 days.Comparison of the two groups for efficient and before and after treatment, blood gas analysis changes, inflammation index. And recorded the intensive care unit (ICU) hospital stay, mortality and other indicators to compare their prognosis. Results The treatment group PaO2, oxygenation index were higher than the control group.The inflammation target was lower than the control group.Differences were statistically (P< 0.01). Compensatory ventilation combined trypsin treatment efficiency of 88.1%,with a control group of 61.5% compared to the differences were statistically (P< 0.01).The treatment group of ICU time, significant live were shorter than the control group, the mortality rate is lower than the control group. Conclusion On the positive treatment of primary disease, on the basis of comprehensive treatment, Compensatory ventilation combined reduced glutathione inhibitor for the treatment of patients with ALI can improve pulmonary function and prognosis ......
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