大剂量沐舒坦对重症肺炎机械通气患者疗效的分析

目的 研究大剂量沐舒坦对重症肺炎机械通气患者的临床疗效.方法 将2011年1月至2012年12月我院60例20 ～ 65岁收住院的重症肺炎呼吸衰竭需行机械通气患者随机分成对照组及观察组,两组均予常规抗感染及机械通气、对症及支持治疗,对照组用沐舒坦60 mg/天,静脉注射；观察组用沐舒坦20 mg/kg·天,静脉三小时微泵注入；分别观察两组治疗前、治疗5天后、治疗7天后的肺损伤评分、PaO2、PaO2/FiO2、肺顺应性（CL）、气道峰压（PIP）、气道阻力（RAW）,机械通气时间及ICU停留时间、4周存活率.结果 大剂量沐舒坦治疗组患者的PaO2、PaO2/FiO2、肺顺应性（CL）、气道峰压（PIP）、气道阻力（RAW）,机械通气时间、ICU停留时间明显较常规剂量组疗效要好（P＜0.05）；两组存活率无明显差异（P＞0.05）.结论 临床上大剂量沐舒坦的应用对重症肺炎应用机械通气的患者的治疗及预后可能有一定的疗效.

Effect of High-dose Mucosolvan applied to the patients with severe pneumonia during mechanical ventilation

Objective To test the effe.cts of high-dose mucosolvan on the patients with severe pneumonia during mechanical ventilation.Method Sixty patients aged from 20 to 65 with severe pneumonia during mechanical ventilation from January 2011 to December 2012 at Shantou Central Hospital were randomized to treatment group and control group.Both groups were applied to antibiotics,mechanical ventilation and supportive care.The treatment group was administered continuous-infusion （CI） schedules of mucosolvan（20mg/kg each day） in three hours and the control group was administered Intravenous injection of mucosolvan（60mg each day）.The lung injury score（LIS）,PaO2,PaO2/FiO2,lung compliance,peak inspiratory pressure（PIP）,airway resistance（RAW）,prolonged mechanical ventilation,length of stay in intensive care unit（ICU） and 4-week survival rate were analyzed.Result The curative effect of treatment group is better than the control group（P ＜ 0.05）.In contrast,there is no difference in the 4-week survival rate between the treatment group and the control group（P ＞ 0.05）.Conclusion High-dose mucosolvan may improve clinical outcome in the treatment of patients with severe pneumonia during mechanical ventilation.