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广东省自然科学基金(5000139)

作品数:2 被引量:17H指数:2
相关作者:罗锐军唐柚青段鹏凯文强唐丽群更多>>
相关机构:广州军区广州总医院更多>>
发文基金:广东省自然科学基金更多>>
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Ten-year retrospective analysis of multiple trauma complicated by pulmonary contusion被引量:3
2014年
Background: This study reports a 10-year retrospective analysis of multiple trauma complicated by pulmonary contusion. The purpose of this study is to ascertain the risk factors for mortality due to trauma in patients with pulmonary contusion, the impact of various treatment options for prognosis, and the risk factors for concurrent Acute Respiratory Distress Syndrome(ARDS). Methods: We retrospectively analyzed 252 trauma patients with lung contusion admitted to the General Hospital of Guangzhou Military Command from January 2000 to June 2011 by using the statistical processing system SPSS 17.0 for Windows. Results: We included 252 patients in our study, including 214 males and 38 females. The average age was 37.1±14.9 years. There were 110 cases admitted to the ICU, of which 26 cases with ARDS. Nine of the 252 patients died. We compared those who survived with those who died by gender and age, the difference was not statistically significant(P=0.199, P=0.200). Separate univariate analysis of those who died and those who survived found that shock on admission(P=0.000), coagulation disorders(P=0.000), gastrointestinal bleeding(P=0.02), the need for emergency surgery on admission(P=0.000), pre-hospital intubation(P=0.000), blood transfusion within 24 hours(P=0.006), the use of mechanical ventilation(P=0.000), and concurrent ARDS(P=0.000) are poor prognosis risk factors. Further logistic analysis, including the admission GCS score(OR=0.708, 95%CI 0.516-0.971, P=0.032), ISS score(OR 1.135, 95%CI 1.006-1.280, P=0.039), and concurrent ARDS(OR=15.814, 95%CI 1.819-137.480, P=0.012), identified the GCS score, ISS score and concurrent ARDS as independent risk factors of poor prognosis. Shock(OR=9.121, 95%CI 0.857-97.060, P=0.067) was also related to poor prognosis. Patients with injury factors such as road accident, falling injury, blunt injury and crush injury, et al.(P=0.039), infection(P=0.005), shock(P=0.004), coagulation disorders(P=0.006), emergency surgery(P=0.01), pre-hospital intubation(P=0.000), chest tube inser
Hui JinLi-Qun TangZhi-Guo PanNa PengQiang WenYou-Qing TangLei Su
乌司他丁联合胸腺肽α1对脓毒症患者免疫调理的临床疗效观察被引量:14
2009年
目的分析乌司他丁联合胸腺肽α1对脓毒症患者免疫调理的临床疗效。方法采用随机对照研究方法收集2004年10月-2008年6月本院重症监护病房(ICU)符合入选标准的脓毒症患者242例。对照组114例,采用2004年脓毒症诊治指南规范的经典治疗方案,包括早期目标复苏、抗生素治疗、呼吸机支持及血液净化等。治疗组128例,在经典治疗基础上加用乌司他丁200kU静脉滴注,每日2次、连用4d后改为100kU静脉泵入,每日2次、连用6d;同时胸腺肽α1(迈普新)1.6mg皮下注射,每日2次、连用4d后改为每日1次、连用6d。疗程均为10d。观察两组患者一般情况,记录急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分。取外周血,用酶联免疫吸附法(ELISA)检测血清白细胞介素-6(IL-6)、IL-10含量,流式细胞仪检测CD14^+单核细胞人白细胞DR抗原(HLA—DR)表达率及辅助性T细胞Th1型细胞因子弘干扰素(CD4^+IFN-γ^+)与Th2型细胞因子(CD4^+IL-4^+)比值。终末观察指标为感染病程、机械通气时间、ICU住院天数、多器官功能障碍综合征(MODS)发生率及28d病死率。结果两组患者治疗前各指标比较差异均无统计学意义(P均〉0.05)。治疗组治疗后外周血CD14^+单核细胞HLA—DR表达率、CD4^+IFN-γ^+/CD4^+IL-4^+比值均明显升高(P均〈0.05);血清IL-6、IL-10含量及APACHEⅡ评分均明显下降,且与对照组比较差异亦有统计学意义(P均〈0.05)。治疗组MODS发生率明显低于对照组(21%比47%,P〈0.05),机械通气时间明显缩短[(6.08±2.46)d比(8.23±3.47)d,P〈0.053;而两组间感染病程及ICU住院天数比较差异均无统计学意义(P均〉0.05)。治疗组28d病死率明显低于对照组(20%比33%,P〈0.05)。结论给予脓毒症患者乌司他丁和胸腺肽α1联用的免疫调�
苏磊孟繁甦唐柚青文强刘云松唐丽群段鹏凯罗锐军
关键词:脓毒症乌司他丁胸腺肽Α1免疫调理辅助性T细胞CD14^+单核细胞
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