血必净注射液对严重创伤患者血管外肺水的影响

目的临床观察血必净注射液对严重创伤患者血管外肺水(EVLW)的影响,以评价血必净注射液对严重创伤的治疗作用。方法根据创伤严重程度评分(ISS)选取40例严重创伤患者,随机分成血必净治疗组(n=22)和对照组(n=18),均予以接PICCO监护仪测得治疗前、治疗后第1、2、3、4、5天EVLW,并同步监测氧合指数(PaO2/FiO2)和C反应蛋白,对2组所得数据进行统计学分析。结果 (1)2组患者EVLW在治疗前均有增高,对照组在2 d时EVLW升至最高峰,以后逐渐下降,4～5 d降到正常,而血必净治疗组EVLW无明显上升趋势,2 d后开始下降,4 d时降至正常,2组EVLW比较差异有统计学意义(P<0.05);血必净治疗组在治疗后3～5 d,EVLW较治疗前有明显下降(P<0.01)。(2)2组氧合指数治疗前均有下降,血必净治疗组治疗第2天时氧合即升至正常,3～5 d时较治疗前有明显升高(P<0.01),对照组氧合指数在2 d时降至最低,4～5 d后升至正常,2组比较差异有统计学意义(P<0.05)。(3)2组CRP在治疗2～5 d后差异有统计学意义(P<0.05),血必净治疗组在治疗后4～5 d CRP较治疗前有显著降低(P<0.05)。结论血必净注射液通过对炎性反应的抑制作用,可降低严重创伤患者的血管外肺水,改善患者的氧合,对防止严重创伤后发生ARDS是有利的。

Effects of Xuebijing injection on severe traumatic patients' extravascular lung water

Objective To observe the effects on severe traumatic patients’ extravascular lung water,in order to assess the curative effect about Xuebijing injection.Methods According to the injury severity score(ISS) selected 40 severe traumatic patients,they were randomly divided into Xuebijing injection group(n=22)and control group(n=18),all of them were to be connected PICCO monitor measured EVLW at 1days,2 days,3 days,4 days,5 days,also got their PaO2/FiO2 and CRP,analyzed each statistical data.Results ① The two groups’ EVLW were both raised,the control group’s EVLW reached its peak after 2 days,then gradually declined,returned to normal after 4-5 days,however Xuebijing injection group’s EVLW didn’t increase,declined after 2 days,returned to normal after 4 days,the two groups’EVLW showed significant difference(P<0.05).There were significant difference of EVLW between beginning and 3-5 days’ treatment in xuebijing injection group(P<0.01).②The two groups’ PaO2/FiO2 were declined at first,Xuebijing injection group’s PaO2/FiO2 got normal at 2 days,it had significant difference after 3-5 days(P<0.01),control group’s PaO2/FiO2 reached the nadir at 2 days,then increased,returned to normal after 4-5 days,the two groups also had significant difference(P<0.05).③The two groups’ CRP had significant difference(P<0.05) after 2-5 days,Xuebijing injection group’s CRP declined after 4-5 days(P<0.05).Conclusion Xuebijing injection can inhibit the releasing of inflammatory factors,decline the severe traumatic patients’ extravascular lung water,improve patients’ PaO2/FiO2,so Xuebijing injection can prevent severe traumatic patients’ from occurring ARDS.