己酮可可碱治疗胸部开放伤海水浸泡的疗效观察

目的探讨己酮可可碱（pentoxifylline,PTX）对胸部开放伤海水浸泡的治疗效果。方法 80例胸部开放伤海水浸泡患者随机分成两组,对照组40例采用常规治疗,包括抗休克、手术、纠正高渗、高钠、高氯血症、纠正酸中毒、抗感染、复温;治疗组40例在常规治疗的基础上加用PTX等综合治疗法。检测动脉血气、血浆渗透压、电解质和治疗疗效,对两组结果进行比较。结果治疗4h后治疗组pH值、二氧化碳分压、氧分压、血浆渗透压接近正常;6h后血电解质达到正常水平;治疗组与对照组治愈率分别为97.5%和77.5%。治疗组各项监测指标与对照组比较差异有统计学意义（P〈0.01）。结论 PTX能够抑制肿瘤坏死因子α（tumor necrosis factor-α,TNF-α）的产生,降低肺微血管通透性,对胸部开放伤后海水浸泡致急性肺损伤（acute lung injury,ALI）有一定的保护作用。PTX综合治疗对胸部开放伤后海水浸泡具有显著疗效。

Therapeutic Effect of Pentoxifylline on Open Trauma Chests with Seawater Immersion

Objective To investigate the therapeutic effect of pentoxifylline on thoracic open trauma with seawater immersion.Methods Eighty patients with thoracic open trauma with seawater immersion were randomly divided into two groups.Forty patients in the control group underwent routine treatment,including early first aid,surgical operation,correction of electrolyte imbalance and metabolic acidosis and anti-infection.Forty patients in the treatment group were treated by routine treatment plus pentoxifylline.Changes of arterial blood gas,plasma osmotic pressure,electrolyte and therapeutic effect were compared between the two groups.Results In treatment group,pH value,carbon dioxide partial pressure,partial oxygen pressure,plasma osmotic pressure approached normal 4 hours after treatment with serum electrolytes being normal 6 hours after treatment.Cure rates were 97.5% and 77.5% in the treatment group and the control group respectively,with all the indexes being significantly higher in treatment group than control group（P0.01）.Conclusion Pentoxifylline can inhibit production of tumor necrosis factor-α（TNF-α）,decrease pulmonary microvascular permeability and protect the lungs from acute injury resulting from seawater immersion after thoracic open trauma.Combined treatment with pentoxifylline and routine therapy can obviously increase the cure rate of thoracic open trauma with seawater immersion.