大剂量甲强龙对重症急性胰腺炎肺损伤的防治研究
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摘要
目的:探讨大剂量甲强龙对重症急性胰腺炎肺损伤的防治研究。方法:选取2013年12月—2018年11月我院收治的重症急性胰腺炎患者300例,将所选患者随机平均分为两组,对照组患者采取常规综合治疗,研究组患者采取大剂量甲强龙进行治疗。治疗3～5天后,分别对两组重症急性胰腺炎患者低氧血症的治疗有效率进行比较。对两组重症急性胰腺炎患者ARDS(PaO_2/FiO2≤200)发生率、死亡发生率以及住院天数进行比较。结果:研究组患者低氧血症的治疗有效率明显高于对照组患者(P<0.05)。研究组患者ARDS(PaO_2/FiO2≤200)发生率、死亡发生率显著低于对照组患者(P<0.05),且研究组患者住院天数明显少于对照组(P<0.05)。结论:在治疗过程当中,对重症急性胰腺炎患者采用大剂量甲强龙进行治疗,在患者肺损伤的防治方面有显著作用,该方法可以降低患者的ARDS(PaO_2/FiO2≤200)发生率及死亡率,减少患者住院天数,有助于患者病情的恢复。
Objective: To study the prevention and treatment of severe acute pancreatitis and lung injury with high dose of medinosaurus. Methods: 300 patients with severe acute pancreatitis admitted to our hospital from December 2013 to November 2018 were selected, and randomly divided into two groups on average. The control group received conventional comprehensive treatment, and the study group patients were treated with highdose methiolone. Three to five days after treatment, the therapeutic efficiency of hypoxemia in two groups of severe acute pancreatitis patients was compared. The incidence of ARDS(PaO_2/FiO2 less than or less than 200), the death rate and the number of days of hospitalization in two groups of severe acute pancreatitis patients were compared. Results: the therapeutic efficiency of hypoxemia in the study group was significantly higher than that in the control group(P<0.05). The incidence and mortality of ARDS(PaO_2/FiO2 less than or less than 200) in the study group were significantly lower than those in the control group(P<0.05), and the number of hospitalization days in the study group was significantly lower than that in the control group(P<0.05). Conclusion: In the treatment process, using high-dose methylprednisolone in patients with severe acute pancreatitis treatment has a significant role in prevention and control of patients with lung injury. This method can reduce the patients' incidence of ARDS(PaO_2/FiO2, 200 or less) and mortality, reduce the patients' hospitalization days, contribute to the recovery of patients; therefore, it should be promoted in clinic.
Objective: To study the prevention and treatment of severe acute pancreatitis and lung injury with high dose of medinosaurus. Methods: 300 patients with severe acute pancreatitis admitted to our hospital from December 2013 to November 2018 were selected, and randomly divided into two groups on average. The control group received conventional comprehensive treatment, and the study group patients were treated with highdose methiolone. Three to five days after treatment, the therapeutic efficiency of hypoxemia in two groups of severe acute pancreatitis patients was compared. The incidence of ARDS(PaO_2/FiO2 less than or less than 200), the death rate and the number of days of hospitalization in two groups of severe acute pancreatitis patients were compared. Results: the therapeutic efficiency of hypoxemia in the study group was significantly higher than that in the control group(P<0.05). The incidence and mortality of ARDS(PaO_2/FiO2 less than or less than 200) in the study group were significantly lower than those in the control group(P<0.05), and the number of hospitalization days in the study group was significantly lower than that in the control group(P<0.05). Conclusion: In the treatment process, using high-dose methylprednisolone in patients with severe acute pancreatitis treatment has a significant role in prevention and control of patients with lung injury. This method can reduce the patients' incidence of ARDS(PaO_2/FiO2, 200 or less) and mortality, reduce the patients' hospitalization days, contribute to the recovery of patients; therefore, it should be promoted in clinic.
引文
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[9]叶荔,归青巧.集束化干预在低分子肝素雾化吸入治疗小儿肺损伤中的干预效果研究[J].药品评价, 2017, 14(23):23-25.
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[3]李涛,刘源,李冉,等.氯膦酸二钠脂质体对大鼠重症急性胰腺炎肺损伤的影响及与Akt、MAPK(ERK1/2)通路的关系[J].中国普通外科杂志,2016, 25(3):350-356.
[4]李靖华,张涛,张胜逆,等.水通道蛋白-1及核因子κB在大鼠重症急性胰腺炎肺损伤中的表达及意义[J].中华消化外科杂志, 2016, 15(8):830-835.
[5]陈辰,石乔,余佳,等.氢饱和生理盐水对重症急性胰腺炎肺损伤的作用及对NOX2/ROS/NF-κB通路的影响[J].中国普通外科杂志, 2016, 25(3):363-369.
[6]王晖,晁华绒,张昕,等.甲强龙、氯胺酮、乌司他丁预处理对单肺通气麻醉所致炎性肺损伤的保护作用比较[J].山东医药, 2017, 57(13):95-97.
[7]吉瑜虹,黄伸伸,巩秀丽,等.人参皂苷预处理对急性肺损伤大鼠肿瘤坏死因子-α和白细胞介素-6及白细胞介素-10水平的影响[J].中国临床药理学杂志, 2017, 33(16):1552-1555.
[8]秦超,关磊,徐田磊,等.CYLD在急性胰腺炎肺损伤中的表达及其与NF-κB通路关系的体外研究[J].中国普通外科杂志, 2016, 25(3):357-362.
[9]叶荔,归青巧.集束化干预在低分子肝素雾化吸入治疗小儿肺损伤中的干预效果研究[J].药品评价, 2017, 14(23):23-25.
[10]周莲英.采用生长抑素治疗急性胰腺炎的临床护理干预[J].药品评价,2016, 18(5):61-63.