胃胀舒合剂治疗ICU机械通气并发腹胀患者的临床观察.docVIP

胃胀舒合剂治疗ICU机械通气并发腹胀患者的临床观察 ［摘要］目的观察胃胀舒合剂治疗ICU机械通气并发腹胀患者的临床疗效。 方法选择2014年1月~ 2015年3月入住我院ICU行机械通气并发腹胀患者 60例随机分为A、B两组，每组30例。A组给予胃胀舒合剂应用，B组给予多 潘立酮片应用。观察两组患者的首次排便时间、腹胀持续时间、机械通气时间, 对治疗前后患者的腹围、潮气量、气道平台压、气道峰压及肺顺应性的变化进行 记录。结果A组排便时间、腹胀持续时间、机械通气时间以及治疗前后腹围、 潮气量、气道平台压、气道峰压及肺顺应性的变化与B组比较差异有统计学意 义(P0.05 )。结论胃胀舒合剂用于ICU机械通气患者能够有效缓解腹胀， 有助于提高患者的潮气量、降低气道峰压及平台压、改善肺顺应性，缩短机械通 气时间。 ［关键词］胃胀舒合剂；ICU ;机械通气；腹胀 ［Abstract］ Objective To observe the clinical effect of Weizhangshu mixture in the treatment of patients in ICU receiving mechanical ventilation and complicated with abdominal distension. Methods A total of 60 patients in our ICU from January 2014 to March 2015 which received mechanical ventilation and complicated with abdominal distension were randomly divided into two groups ( 30 each group ): Weizhangshu mixture ( group A ) and domperidone tablets ( group B ). The defecate time , abdomi nal diste nsion du rati on , mecha nical ventilation time were observed. The abdominal perimeter, tidal volume (VT ) ,airway plateau pressure( Pplat) z peak airway pressure ( Ppeak ), lung compliance ( CL ) were recorded before and after the treatment. Results There was statistical difference in the defecate time , abdominal diste nsion du rati on and mecha nical ven tilati on time betwee n group A and group B( P0.01) ; The abdominal perimeter, VT , Pplat z Ppeak , CL before and after the treatment also had statistical difference( P0.05 ). Conclusion Weizhangshu mixture can be used in ICU patients receiving mechanical ventilation to relieve abdominal distension , and it can be helpful to raise tidal volume , reduce airway plateau pressure and peak pressure , improve lung complianee and shorten mechanical ventilation time. [Key words] Weizhangshu mixture ; ICU ; Mechanical ventilation ; Abdominal distension 目前机械通气是ICU救治各种原因引起呼吸衰竭的重要手段。ICU患者病 情危重，由于疾病本身、人工气道的建立以及长期卧床，多数患者会出现腹胀[1 , 2]，导致膈肌抬高、胸腔内压增加、肺顺应性降低，进而弓I起通气血流比例失调、 通气量下降[3,4],直接影响了机械通气效果。目前多数ICU采用多潘立酮等胃 肠动力药物改善腹胀，但疗效有限，而祖国医学对于腹胀的认识源远流长，治疗 经验丰富。胃胀舒合剂为我院院内