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目的 观察前列腺素 E1 (PGE1 )对呼吸窘迫综合征 (ARDS)病人氧供和氧耗及预后的影响。方法 将 18例 ARDS病人 ,根据治疗情况和预后分为 4组 :对照生存组 (CS) (n=4) ,对照死亡组 (CD) (n=4) ,PGE1 治疗生存组 (PS) (n=6 ) ,PGE1 治疗死亡组 (PD) (n=4)。所有病人入 ICU后接受常规治疗和呼吸机治疗 ,均用异丙酚加芬太尼混合液或咪唑安定加芬太尼混合液持续镇静。在入ICU时置入 Swan- Ganz导管 ,监测血液动力学的同时采外周动脉和混合静脉血测定血气 ,计算DO2 I、VO2 I、ERO2 。并在入 ICU后第 1天、第 2天、第 3天及出 ICU时重复测定上述指标。结果 在ICU治疗期间 ,对照组 (CS、CD)病人的 DO2 无明显变化 ,CD组 VO2 和 ERO2 均上升 ,而 CS组 VO2和 ERO2 均下降。治疗组 (PD、PS组 ) DO2 、VO2 均升高 ,而 ERO2 无明显变化。结论 PGE1 30 ng·kg- 1 · m in- 1 可改善 ARDS病人的氧供和氧耗 ,但对生存率无明显影响。
Objective To investigate the effect of prostaglandin E1 (PGE1) on the oxygenation and prognosis of patients with respiratory distress syndrome (ARDS). Methods 18 patients with ARDS were divided into 4 groups according to the treatment and prognosis: control survival group (CS) (n = 4), control death group (CD 4), PGE1 treatment survival group = 6), PGE1-treated death group (PD) (n = 4). All patients received ICU routine treatment and ventilator therapy, were treated with propofol plus fentanyl mixture or midazolam plus fentanyl mixture continued calm. The Swan-Ganz catheter was inserted into the ICU, hemodynamics were monitored while the peripheral blood and mixed venous blood were measured for blood gas, and DO2 I, VO2 I and ERO2 were calculated. The above indexes were measured repeatedly on the first day, the second day, the third day and the ICU after entering the ICU. Results There was no significant change in DO2 in control group (CS, CD) patients during the course of ICU. Both VO2 and ERO2 in CD group increased while VO2 and ERO2 in CS group decreased. DO2 and VO2 in the treatment group (PD, PS group) were increased, while ERO2 had no significant change. Conclusion PGE1 30 ng · kg-1 · m-1 can improve oxygen supply and oxygen consumption of patients with ARDS, but have no significant effect on the survival rate.