丹参多酚酸盐对有创机械通气的急性加重期慢性阻塞性肺疾病患者肺部感染的影响

摘要

Objective To explore the effect of salvianolate on the incidence of pulmonary infection in patients with acute exacerbation of chronic obstructive pulmonary disease ( AECOPD ) undergoing invasive mechanical ventilation.Methods Forty patients with AECOPD undergoing invasive mechanical ventilation were divided into two groups by random number table.Twenty cases in the control group were treated with invasive mechanical ventilation and conventional western medicine treatment,while 20 cases in the observation group received intravenous infusion of salvianolate(200 mg/time,once daily) besides the therapies applied to control group.The incidences of ventilator-associated pneumonia (VAP) were compared between two groups.Before and after the treatment,pH value of arterial blood,partial pressure of oxygen(PaO2), partial pressure of carbon dioxide( PaCO2 ) and oxygen saturation( SaO2 ) of arterial blood,duration of mechanical ventilation treatment and clinical pulmonary infection score( CPIS) were also compared between two groups.Results There were no significant differences in pH, PaO2,PaCO2,SaO2 or CPIS between two groups before treatment(all P>0.05).pH,PaO2,PaCO2,SaO2 and CPIS of observation group and pH,PaO2,SaO2 and CPIS of control groups improved significantly after treatment(P<0.05),and the improvement of each index of observation group was superior to that of control group(P<0.05).The duration of mechanical ventilation treatment in the observation group was significantly less than that in the control group((9.38 ±4.27)days vs.(13.91 ±7.78)days,P<0.05).The incidence of VAP in the observation group was significantly lower than that in the control group(15.0%(3/20) vs.45.0%(9/20),P<0.05).Conclusion For the patients with AECOPD undergoing invasive mechanical ventilation,the application of salvianolate can improve arterial blood gas index, reduce the incidence of VAP and the duration of mechanical ventilation treatment,and improve the clinical prognosis.%目的 探讨丹参多酚酸盐对有创机械通气的急性加重期慢性阻塞性肺疾病( AECOPD)患者肺部感染发生率的影响. 方法 行有创机械通气治疗的AECOPD患者40例,依据数字分组法随机分为两组,各20例. 对照组给予有创机械通气和常规西药治疗,观察组在对照组基础上加用丹参多酚酸盐静脉滴注. 对比两组呼吸机相关性肺部感染( VAP)发生率,以及治疗前后动脉血液酸碱度( pH)、氧分压( PaO2 )、二氧化碳分压( PaCO2 )、血氧饱和度( SaO2 )、机械通气时间及临床肺部感染评分(CPIS)变化. 结果 治疗前两组pH、PaO2、PaCO2、SaO2 及CPIS比较,差异无统计学意义(P均>0.05);治疗后观察组pH、PaO2、PaCO2、SaO2 及CPIS和对照组较治疗前均明显改善(P<0.05),且观察组各指标改善明显优于对照组(P<0.05). 观察组机械通气时间为(9.38 ±4.27)d,明显短于对照组的(13.91 ±7.78)d(P <0.05);观察组 VAP 发生率15.0%(3/20),明显低于对照组的45.0%(9/20)(P<0.05). 结论 丹参多酚酸盐可改善有创机械通气的AECOPD患者动脉血气指标,降低VAP发生率,缩短有创机械通气时间,改善临床预后.