【摘要】 目的 比較薤白聯(lián)合阿司匹林或單用阿司匹林防治心腦血管事件的療效。 方法 2007年1月〖CD3/5〗2009年9月就診的188例高?；颊呒{入研究,隨機(jī)分為實(shí)驗(yàn)組(89例)和對(duì)照組(99例)。兩組均予口服阿司匹林0.1 g,1次/d。實(shí)驗(yàn)組同時(shí)給予口服薤白0.9 g,3次/d。觀察兩組患者血管事件的發(fā)生率和不良反應(yīng)的發(fā)生情況。 結(jié)果 實(shí)驗(yàn)組血管總事件發(fā)生率為6.7%,對(duì)照組為19.2%,兩組間差異有統(tǒng)計(jì)學(xué)意義(Plt;0.05);實(shí)驗(yàn)組腦梗死發(fā)生率為1.1%,對(duì)照組為9.1%,兩組間差異有統(tǒng)計(jì)學(xué)意義(Plt;0.05)。兩組短暫性腦缺血、心絞痛、心肌梗死的發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(Pgt;0.05)。兩組皮下出血、血尿、黑便、惡心、腹痛等不良反應(yīng)的發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(Pgt;0.05)。 結(jié)論 服用阿司匹林加薤白可顯著降低高危患者心腦血管總事件發(fā)生率和腦梗死發(fā)生率,增加療效,而不良反應(yīng)沒(méi)有顯著增加?！続bstract】 Objective Compare the curative effect of cerebrovascular diseases event prevented with llium macrostemon and aspirin or only with aspirin. Methods Divide the outpatient patients into experimental group (89 patients) and control group (99 patients). Use 0.1 g aspirin for two groups with oral administration once per day. The experimental group is used with 0.9 g allium macrostemon with oral administration three times per day. Observe the generation rate and adverse reaction of vascular events in two groups of patients. Results The Total generation rate of vascular events in the experimental group is 6.7% and the control group is 19.2%,the differences were statistically significant (Plt;0.05); the cerebral infarction generation rate in the experimental group is 1.1% and in the control group is 9.1%,the differences were statistically significant (Plt;0.05). There is no significant difference (Pgt;0.05) in TIA, angina pectoris, myocardial infarction generation rate in two groups. There is no significant difference (Pgt;005) in adverse reaction generation rate of subcutaneous hemorrhage, hematuria, melena, nausea, bellyache. Conclusion Taking aspirin with llium macrostemon can significantly decrease total cardiovascular and cerebrovascular events generation rate and cerebral infarction generation rate in high risk patients, improve the curative effect and the adverse reaction has not been significantly increased.
目的探討無(wú)創(chuàng)正壓通氣在撤機(jī)相關(guān)性肺水腫高風(fēng)險(xiǎn)患者中的應(yīng)用價(jià)值。方法納入 2018 年 6 月至 2019 年 6 月收住于蘭州大學(xué)第一醫(yī)院重癥醫(yī)學(xué)科機(jī)械通氣撤機(jī)患者 63 例。采用隨機(jī)數(shù)字表法隨機(jī)分為兩組并將產(chǎn)生的隨機(jī)數(shù)字分配隱藏于不透光信封中，試驗(yàn)組接受無(wú)創(chuàng)正壓通氣（n=32），對(duì)照組接受面罩氧療通氣（n=31）。比較兩組撤機(jī) 2 h 后患者心率、呼吸頻率、平均動(dòng)脈壓、低氧血癥發(fā)生、再次插管發(fā)生、血?dú)夥治龅戎笜?biāo)，同時(shí)比較兩組患者住院時(shí)間、28 d 病死率及并發(fā)癥等情況。結(jié)果撤機(jī) 2 h 后無(wú)創(chuàng)正壓通氣組患者心率、呼吸頻率顯著低于面罩組（P<0.05），兩組患者平均動(dòng)脈壓無(wú)差異，無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05），無(wú)創(chuàng)正壓通氣組患者在低氧血癥、喉頭水腫及再次插管發(fā)生率方面顯著低于面罩組，存在統(tǒng)計(jì)學(xué)意義（P<0.05），血?dú)夥治鲋笜?biāo)優(yōu)于面罩組（P<0.05），無(wú)創(chuàng)正壓通氣組患者在住院時(shí)間及住重癥加強(qiáng)治療病房時(shí)間方面明顯短于面罩組（P<0.05），28 d 病死率低于面罩組（P<0.05），而兩組在氣管切開(kāi)發(fā)生、氣胸及皮下氣腫方面并無(wú)差異（P>0.05）。結(jié)論無(wú)創(chuàng)正壓通氣可有效預(yù)防撤機(jī)相關(guān)性肺水腫高?；颊叩脱跹Y、喉頭水腫、再次氣管插管的發(fā)生，同時(shí)可縮短患者的住院時(shí)間，值得臨床重視并推廣。