中国临床药理学杂志2024，Vol.40Issue(6)：792-796,5.DOI:10.13699/j.cnki.1001-6821.2024.06.002
苯磺顺阿曲库铵辅助中重度ARDS患者俯卧位机械通气的临床研究
Clinical trial of cisatracurium besilate assisted prone position mechanical ventilation in patients with moderate to severe ARDS
摘要
Abstract
Objective To analyze the application effect of cisatracurium besilate assisted mechanical ventilation in patients with moderate to severe acute respiratory distress syndrome(ARDS)and the impact on prognosis.Methods Patients with moderate to severe ARDS were divided into the control group and the treatment group according to different treatment methods using cohort method.The control group was treated with mechanical ventilation in prone position.The treatment group was treated with cisatracurium besilate(0.15 mg·kg-1)assisted mechanical ventilation in prone position.The duration of mechanical ventilation,weaning time,total length of hospital stay,ventilator-related parameters[arterial partial pressure of oxygen(PaO2),oxygenation index(OI)and central venous pressure(CVP)],the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)scores,Sequential Organ Failure Assessment Scale(SOFA)scores,inflammatory factors[interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor-α(TNF-α)],short-term mortality and the incidence of complications were compared between the groups.Results The treatment group and the control group included 39 and 41 cases,respectively.The offline duration for the treatment group and the control group were(15.11±1.97)and(12.01±1.62)days,with statistically significant differences(P＜0.05).Three days after mechanical ventilation,the PaO2 for the treatment group and the control group were(88.24±9.05)and(80.01±8.34)mmHg;OI were(219.87±22.01)and(170.86±18.53)mmHg·％-1;IL-6 was(18.04±1.92)and(26.23±3.04)ng·mL-1,respectively.After treatment,the APACHE Ⅱ scores for the treatment group and the control group were(16.05±1.74)and(20.05±1.08)points;the SOFA scores were(5.04±0.66)and(7.23±1.05)points.The mortality rates within 90 days after discharge for the treatment group and the control group were 2.56％and 19.51％,and the overall complication rates were 7.69％and 29.27％.Statistically significant differences were observed in the comparison of the above indicators between the treatment group and the control group(all P＜0.05).The death rate of the treatment group within 90 days after discharge(2.56％)was significantly lower than that of the control group(19.51％,P＜0.05),and the total complication rate(7.69％)was significantly lower than that of the control group(29.27％,P＜0.05).Conclusion Cisatracurium besilate assisted mechanical ventilation in prone position has a definite application effect in patients with moderate to severe ARDS,and can effectively improve the prognosis.关键词
苯磺顺阿曲库铵/呼吸窘迫综合征/中重度/俯卧位机械通气/预后Key words
cisatracurium besilate/respiratory distress syndrome/moderate to severe/mechanical ventilation in prone position/prognosis分类
医药卫生引用本文复制引用
胡军军,黄建东,卢周晓,胡壮文..苯磺顺阿曲库铵辅助中重度ARDS患者俯卧位机械通气的临床研究[J].中国临床药理学杂志,2024,40(6):792-796,5.基金项目
金华市公益性技术应用研究基金资助项目(2023-4-184) （2023-4-184）
