[1]吴 强.地塞米松在早期急诊中暑患者的应用效果[J].医学信息,2020,33(22):156-157,160.[doi:10.3969/j.issn.1006-1959.2020.22.045]
　WU Qiang.Application Effect of Dexamethasone in Early Emergency Patients with Heatstroke[J].Medical Information,2020,33(22):156-157,160.[doi:10.3969/j.issn.1006-1959.2020.22.045]
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地塞米松在早期急诊中暑患者的应用效果()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年22期
页码:
156-157,160
栏目:
药物与临床
出版日期:
2020-11-15

文章信息/Info

Title:
Application Effect of Dexamethasone in Early Emergency Patients with Heatstroke
文章编号:
1006-1959（2020）22-0156-03
作者:
吴 强
（海军第971医院第三派驻门诊部，山东 青岛 266041）
Author(s):
WU Qiang
(Naval Hospital No.971 Third Outpatient Department,Qingdao 266041,Shandong,China)
关键词:
中暑; 地塞米松; 临床症状改善时间; 动脉血气水平
Keywords:
Heatstroke; Dexamethasone; Time to improve clinical symptoms; Arterial blood gas level
分类号:
R594.1+2
DOI:
10.3969/j.issn.1006-1959.2020.22.045
文献标志码:
A
摘要:
目的 探讨急诊中暑患者早期应用地塞米松治疗的效果。方法 收集2017年1月~2019年12月我院急诊收治的48例中暑患者临床资料，按照治疗方法不同分为对照组22例和观察组26例。对照组采用常规疗法治疗，观察组采用常规疗法+地塞米松治疗，比较两组临床症状及重要脏器功能改善时间、动脉血气指标[碳酸氢根（HCO3-）、动脉血氧分压（PaO2）、血氧饱和度（SaO2）]水平、相关生化指标[血清肌酐（Scr）、活化部分凝血活酶时间（APTT）、肌酸激酶同工酶（CK-MB）]水平及不良反应发生率。结果 观察组体温恢复正常、肝肾功能恢复正常、心肌酶恢复正常及临床症状消失时间均短于对照组，差异有统计学意义（P＜0.05）；观察组HCO3-、PaO2、SaO2水平高于对照组，差异有统计学意义（P＜0.05）；观察组Scr、APTT水平低于对照组，CK-MB水平高于对照组，差异有统计学意义（P＜0.05）；观察组不良反应发生率为7.69%，与对照组的9.09%比较，差异无统计学意义（P＞0.05）。结论 急诊中暑患者早期应用地塞米松治疗能够有效缩短临床症状及重要脏器功能改善时间，改善动脉血气及生化指标异常水平，且不会增加不良反应发生率，安全性较好。
Abstract:
Objective To investigate the effect of dexamethasone treatment in emergency heatstroke patients.Methods To collect the clinical data of 48 cases of heatstroke patients admitted in our hospital from January 2017 to December 2019,the data of 22 patients treated with conventional therapy were included in the control group, 26 patients treated with routine dexamethasone were included in the observation group.The clinical symptoms and organ function improvement time, arterial blood gas index (HCO3-), arterial blood oxygen partial pressure (PaO2), blood oxygen saturation (SaO2) were compared between the two groups [serum creatinine (Scr), activated partial thromboplastin time (APTT), creatine kinase isoenzyme (CK-MB)] levels and incidence of adverse reactions.Results The observation group’s body temperature returned to normal, liver and kidney function returned to normal, myocardial enzymes returned to normal, and the disappearance of clinical symptoms were shorter than the control group, the difference was statistically significant (P<0.05); the observation group’s HCO3-, PaO2, and SaO2 levels were higher than the control group, the difference was statistically significant (P<0.05); the level of Scr and APTT in the observation group was lower than that of the control group, and the level of CK-MB was higher than that of the control group, the difference was statistically significant (P<0.05); the incidence of adverse reactions in the observation group was 7.69%, compared with 9.09% in the control group, the difference was not statistically significant (P>0.05).Conclusion Early application of dexamethasone in emergency heatstroke patients can effectively shorten the improvement time of clinical symptoms and important organ function, improve the abnormal level of arterial blood gas and biochemical indexes, and do not increase the incidence of adverse reactions, and the safety is good.

参考文献/References:

[1]葛瑾,赵冰梅.急诊中暑患者治疗中地塞米松的应用及预后评价[J].山西医药杂志,2019,48(5):544-546.[2]陈灏,林果为,王吉耀.实用内科学(第14版)[M].北京:人民卫生出版社,2013:678-682.[3]倪啸晓,刘志锋,谢秋幼,等.中暑脑损伤机制及高压氧治疗作用的研究进展[J].中华危重病急救医学,2017,29(6):572-576.[4]殷惠梅,童华生.血小板损伤与中暑发病机制的研究进展[J].临床急诊杂志,2017,18(5):342-344.[5]杨向新,夏亮,刘江伟,等.中暑致肝损伤机制的研究进展[J].现代生物医学进展,2017,17(25):4997-5000.[6]潘开菊,叶秋梅,曹小红,等.中西医联合物理降温对中暑患者降温效果的研究应用[J].中国实用护理杂志,2018,34(36):2851-2854.[7]范华杰,牛磊.中暑患者血清心肌酶水平变化与患者病情判断及预后的关系[J].解放军预防医学杂志,2018,36(3):298-300.[8]喻文,罗红敏.地塞米松可改善大鼠中暑引起的多器官功能障碍和损伤[J].中华危重病急救医学,2015,27(8):638-638.[9]黎振兴,何晟,魏立平,等.地塞米松可增强支气管哮喘小鼠肺组织RECK的表达[J].细胞与分子免疫学杂志,2016,32(5):604-608.[10]徐瑞艳,赵青赞,任秀花,等.糖皮质激素受体激动剂地塞米松对大鼠血清促炎因子IL-6、TNF-α表达及神经病理性疼痛的影响[J].神经解剖学杂志,2017,33(2):202-208.[11]司继刚.地塞米松注射液临床应用安全性分析评价[J].中国药学杂志,2016,51(22):1972-1975.[12]朱荣华,张桂敏,李顺.能谱CT增强检查前应用地塞米松预防不良反应的护理[J].解放军护理杂志,2016,33(24):56-57.

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更新日期/Last Update: 1900-01-01