大黄对机械通气患者呼吸功能的影响

目的探讨大黄对机械通气患者呼吸功能的影响。方法将84例呼吸衰竭患者随机分为2组:对照组采用机械通气和常规西医治疗;治疗组在对照组治疗基础上,采用大黄颗粒剂管饲。观察2组治疗前和治疗后24 h、48 h、72 h、96 h的APACHEⅡ评分、pH、氧合指数、二氧化碳分压、气道阻力、肺顺应性、乳酸值变化,以及2组的平均脱机时间、呼吸机相关肺炎(VAP)和多器官功能障碍综合征(MODS)发生率。结果2组患者治疗24 h后的氧合指数、二氧化碳分压、肺顺应性均较治疗前显著改善(P均<0.05),治疗组pH、氧合指数、乳酸值较对照组亦有显著改善(P均<0.05);48 h后,治疗组APACHEⅡ评分、pH、氧合指数较对照组明显改善(P均<0.05),肺顺应性、气道阻力、乳酸水平较对照组显著改善(P均<0.01)。治疗组各项指标在其后的72 h和96 h保持稳定。对照组在72 h出现乳酸值升高和肺顺应性下降。治疗组平均脱机时间及VAP和MODS发生率与对照组比较有显著性差异。结论大黄通过直接肺保护作用改善组织缺氧,缩短机械通气时间,改善机械通气患者的呼吸功能,降低VAP和MODS发生率。

Effects of Rhubarb on respiratory function in patients with mechanical ventilation

Objective It is to study the effect of Rhubarb on respiratory function in patients with mechanical ventilation.Methods Eighty-four patients with respiratory failure were randomly divided into two groups: the control group(treated with mechanical ventilation and normal western medicine) and the treatment group(treated with Rhubarb as well as mechanical ventilation and western medicine).The APACHEⅡscores,pH,oxygenation index,p(CO2),airway resistance,pulmonary compliance,lactic acid in all the patients were observed before and 24,48,72 and 96 hours after treatment.The average off-line time,ventilation acquired pneumonia and MODS incidence rate were observed after treatment in both groups.Results The oxygenation index,p(CO2),pulmonary compliance were markedly improved 24 hours after the treatment in two groups(P<0.05).The pH,oxygenation index, lactic acid in treatment group were better than that in control group at 24 hours.The APACHEⅡ scores,pH,oxygenation index were better than that in control group(P<0.05) and the pulmonary compliance,airway resistance in treatment group were markedly improved than that in control group(P<0.01) at 48 hours.All indexes in treatment group kept stable at 72,96 hours.The lactic acid was obviously advanced and the pulmonary compliance was markedly decreased in control group at 72 hours than that at 48 hours(P<0.05).There were significances in the average off-line time,VAP,MODS incidence rate between both groups(P<0.05).Conclusion Rhubarb can improve tissue hypoxia and respiratory function of patients with mechanical ventilation by direct lung protection,and can decurtate the average off-line time,decrease incidences of depression VAP and MODS.