中国医科大学学报

中国医科大学学报
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中国医科大学学报 ›› 2017, Vol. 46 ›› Issue (4): 317-320.doi: 10.12007/j.issn.0258-4646.2017.04.008

• 论著 • 上一篇    下一篇

集束化方案治疗急性脑损伤合并急性肺损伤/急性呼吸窘迫综合征疗效分析

张恒,王军,仇波,王运杰   

  1. 中国医科大学附属第一医院神经外科,沈阳 110001
  • 收稿日期:2016-10-15 出版日期:2017-04-30 发布日期:2017-04-19
  • 通讯作者: 王运杰 E-mail:wyj024@vip.sina.com
  • 作者简介:张恒(1974 -),男,主治医师,博士 .
  • 基金资助:
    辽宁省自然科学基金(2014021097)

Bundles of Treatment Protocol for Acute Brain Injury Complicated by Acute Lung Injury or Acute Respiratory Distress Syndrome

ZHANG Heng,WANG Jun,QIU Bo,WANG Yunjie   

  1. Department of Neurosurgery,The First Hospital,China Medical University,Shenyang 110001,China
  • Received:2016-10-15 Online:2017-04-30 Published:2017-04-19

摘要: 目的 评价集束化方案治疗急性脑损伤(ABI)合并急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)的有效性及安全性。方法 将 83 例 ABI 合并 ALI/ARDS 患者随机分为实验组(n = 41)和对照组(n = 42),对照组采用常规集束化方案,实验组采 用强化集束化方案。检测 2 组患者治疗前后的各项指标,评价 2 种方案治疗 ABI 合并 ALI/ARDS 的有效性及安全性。结果 2组患者治疗前后心率、SpO2、PO2/FiO2 比较均有统计学差异(P < 0.05);与对照组比较,实验组 PO2/FiO2 改善更早、更明显,机械通 气时间、入住 ICU 时间、总住院时间均有统计学差异(P < 0.05),而 28 d 病死率及呼吸机相关性肺炎发病率无统计学差异(P >0.05)。结论 集束化方案治疗 ABI 合并 ALI/ARDS 有效;与常规方案相比,强化方案能显著改善氧合,缩短机械通气、入住 ICU及总住院时间。

关键词: 急性脑损伤, 急性肺损伤, 急性呼吸窘迫综合征, 集束化方案

Abstract: Objective To evaluate the efficacy and safety of the bundles of treatment protocol for patients with acute brain injury(ABI)complicated by acute lung injury(ALI)/acute respiratory distress syndrome(ARDS). Methods A total of 83 patients with acute brain injury complicated by ALI/ARDS were randomly divided into experimental group(n = 41)and control group(n = 42).The control group was treated with the routine bundle protocol while the experimental group was treated with an intensive bundle protocolin addition to the routine bundle protocol. The data was collected,and the effectiveness and safety of the two bundles of treatment protocol were evaluated. Results The results of heart rate(HR),SpO2,and PO2/FiO2 in the two groups showed significant differences before and after treatment.The improvement of PO2/FiO2 in the experimental group occurred earlier and was more significant compared tothe control group,24 hours after treatment.The mechanical ventilation time,ICU stay time,and total hospitalization time for the experimental group were significantly different(P < 0.05)from the control group.The 28-day mortality and morbidity of ventilator-associated pneumonia showed no significant difference(P > 0.05) between the two groups. Conclusion The treatment of acute brain injury complicated by ALI/ARDS by the two bundles of treatment protocol is effective. Compared to the conventional treatment bundles,the intensive treatment bundles can significantly improve oxygenation,and shorten the mechanical ventilation time required,as well as ICU and total hospital stay.

Key words: acute brain injury, acute lung injury, acute respiratory distress syndrome, bundles of treatment protocol

中图分类号: 

  • R742.5
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