中国医院用药评价与分析2024，Vol.24Issue(11)：1329-1332,4.DOI:10.14009/j.issn.1672-2124.2024.11.008
西维来司他钠联合APRV治疗小儿重度ARDS的前瞻性随机对照研究
A prospective Randomized Controlled Study of Cilvelestat Sodium Combined with Airway Pressure Release Ventilation in the Treatment of Severe Acute Respiratory Distress Syndrome in Children
摘要
Abstract
OBJECTIVE:To probe into the clinical effects of cilvelestat sodium combined with airway pressure release ventilation(APRV)in the treatment of severe acute respiratory distress syndrome(ARDS)in children.METHODS:A total of 102 children with severe ARDS admitted into the hospital from May 2021 to May 2023 were prospectively selected and divided into the control group and study group according to the random number table method,with 51 cases in each group.The control group was given APRV+basic symptomatic treatment,while the study group received cilvelestat sodium+APRV+basic symptomatic treatment.The clinical signs and symptoms,clinical efficacy and complications,the lung function indicators,arterial blood gas indicators,and inflammatory factor levels before and after treatment were compared between two groups.RESULTS:The total effective rate of the study group was 94.12%(48/51),significantly higher than that 80.39%(41/51)of the control group,the difference was statistically significant(P<0.05).The mechanical ventilation time,disappearance time of shortness of breath,disappearance time of lung rales and length of stay in the study group were shorter than those in the control group,the differences were statistically significant(P<0.05).After 3 and 7 d of treatment,the partial pressure of oxygen(PaO2)and arterial oxygen saturation(SaO2)in both groups were higher than those before treatment,and the partial pressure of carbon dioxide(PaCO2)was lower than that in the control group,and the change range of PaO2,SaO2 and PaCO2 in the study group was greater than that in the control group,with statistically significant differences(P<0.05).After 3 and 7 d of treatment,the maximum expiratory pressure,peak expiratory flow rate,maximum inspiratory pressure,and maximum expiratory mid-flow rate in both groups increased compared with those before treatment,and the study group was higher than the control group;after 3 and 7 d of treatment,the levels of serum C-reactive protein,tumor necrosis factor α,macrophage migration inhibitory factor-1,and interleukin-6 in both groups decreased compared with those before treatment,and the study group was lower than the control group,with statistically significant differences(P<0.05).The incidence of complications in the study group was 5.88%(3/51),lower than the 21.57%(11/51)in the control group,with statistically significant differences(P<0.05).CONCLUSIONS:Cilvelestat sodium combined with APRV is effective in the treatment of severe ARDS in children,which can effectively inhibit the release of serum inflammatory factors,improve blood gas,clinical symptoms and lung function in children,and reduce the occurrence of complications.关键词
西维来司他钠/气道压力释放通气/急性呼吸窘迫综合征/动脉血气/肺功能Key words
Cilvelestat sodium/Airway pressure release ventilation/Acute respiratory distress syndrome/Arterial blood gas/Lung function分类
医药卫生引用本文复制引用
王维娟,李娜,王璐,成钧..西维来司他钠联合APRV治疗小儿重度ARDS的前瞻性随机对照研究[J].中国医院用药评价与分析,2024,24(11):1329-1332,4.基金项目
陕西省重点研发计划项目(No.2021SF-026) （No.2021SF-026）
