發(fā)布時間：2018-06-01 16:54

  本文選題：創(chuàng)傷后急性肺損傷 + 急性呼吸窘迫綜合征�。� 參考：《中華高血壓雜志》2017年03期

【摘要】：目的觀察卡托普利和硝苯地平治療重癥胸外傷致急性肺損傷(ALI)合并高血壓患者的血壓控制情況。方法 2010年1月至2015年12月,入選沈陽醫(yī)學院附屬中心醫(yī)院胸外重癥監(jiān)護病房嚴重創(chuàng)傷致ALI,且合并2級以上高血壓患者105例;分為卡托普利組(常規(guī)治療基礎上+卡托普利片12.5~50.0mg/次,3次/d,口服或鼻飼,n=51)和硝苯地平組(常規(guī)治療基礎上+硝苯地平緩釋片10~20mg/次,3次/d,口服或鼻飼,n=54)。兩組均治療7d。觀察兩組患者的呼吸頻率、氧分壓、急性生理與慢性健康評分(APACHEⅡ)、創(chuàng)傷嚴重程度評分(ISS)、機械通氣時間、住重癥監(jiān)護病房時間、急性呼吸窘迫綜合征(ARDS)的發(fā)生率和病死率。結果治療7d后,卡托普利組呼吸頻率[(15.3±5.4)比(22.4±5.4)次/min]、氧分壓[(78.3±12.2)比(61.5±12.6)mm Hg]、機械通氣時間[(85.4±25.4)比(114.5±22.5)h]、住重癥監(jiān)護病房時間[(5.4±3.1)比(9.5±4.4)d]均優(yōu)于硝苯地平組,ARDS發(fā)生率(37.2%比57.4%)和病死率均(0%比14.8%)低于硝苯地平組(P0.05);而兩組血壓控制總有效率差異無統(tǒng)計學意義。結論在治療重癥胸外傷致創(chuàng)傷后ALI伴高血壓的患者中,控制高血壓滿意且無差異的前提下,卡托普利較硝苯地平更利于ALI的治療。
[Abstract]:Objective to observe the blood pressure control of captopril and nifedipine in the treatment of acute lung injury caused by severe thoracic trauma (ALI) with hypertension. Methods from January 2010 to December 2015, 105 patients with grade 2 hypertension were enrolled in the severe trauma induced by severe trauma in the extrathoracic intensive care unit of the affiliated Central Hospital of Shenyang Medical College. They were divided into two groups: captopril group (12.5~50.0mg/ 3 / d, oral or nasal feeding) and nifedipine group (nifedipine sustained release tablet 10~20mg/ 3 times / d, oral or nasal feeding). Both groups were treated for 7 days. The respiratory frequency, partial pressure of oxygen, acute physiological and chronic health score (Apache 鈪，

本文編號：1964960