目的 探讨东莨菪碱在各种原因引起的急性呼吸窘迫综合征( ARDS)治疗中的价值.方法 把入住我院重症监护室的58例诊断为ARDS患者随机分为对照组和治疗组,两组接受同样治疗,但治疗组加用东莨菪碱,观察对照组和治疗组的氧合变化、胸片渗出吸收时间、上机时间、生存率等的变化情况.结果 两组治疗前后比较:氧分压、氧合指数两组均有明显改善；前3天两组比较,治疗组的氧分压、氧合指数改善、胸片渗出吸收时间均优于对照组,第7天两组相仿；上机时间对照组稍长于治疗组,但无统计学意义(P＞0.05)；生存率两组相仿(P＞0.05).结论 东莨菪碱对ARDS患者早期氧合改善及促进肺部渗出吸收有明显作用,但对患者上机时间及预后无明显改善作用.%Objective To investigate the value of scopolamine in the treatment of ARDS with different etiologies.Methods 58 patients diagnosed as ARDS were randomly divided into study group and control group.The study group received scopolamine in addition to routine medical treatment while the control group received routine treatment.The changes in blood oxygenation,time to absorption of lung infiltrate on chest X-ray,time to use of mechanical ventilation,and survival rate were observed in the two groups.Results After treatment,the partial pressure of oxygen and the oxygenation index were improved in both groups.On days 1 to 3,the study group was superior to the control group in the partial pressure of oxygen,the oxygenation index,and the time to absorption of lung infiltrate,but the two groups were similar on day 7.The time to use of mechanical ventilation was slightly shorter in the study group,with no statistical difference ( P ＞ 0.05 ).The survival rate was similar in the two groups ( P ＞ 0.05).Conclusions Scopolamine plays a significant role in the improvement of blood oxygenation and the absorption of lung infiltrate in the early stage of ARDS,but has no marked action on the shortening of time to use of mechanical ventilation and on the improvement of prognosis.
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