目的 研究羥乙基淀粉130/0.4對外傷后致急性呼吸窘迫綜合征的臨床療效。方法 50例外傷后致呼吸窘迫綜合證的患者隨機(jī)分為治療組（25例）和對照組（25例），兩組患者入院明確診斷后，分別行血常規(guī)、血生化、肝腎功能及血?dú)鈾z查，均給予機(jī)械通氣，呼氣末正壓≥5 cm H2O（1 cm H2O=97.72 Pa）時(shí)，行APACHEⅡ評分，記錄患者體征及氧合指數(shù)，且給予支氣管肺泡灌洗，送支氣管灌洗液（BALF）檢查IL-6及白蛋白；對照組給予林格氏液1 000 mL，靜脈滴注，1 次/d；治療組患者給予羥乙基淀粉130/0.4 1 000 mL，靜脈滴注，1 次/d，兩組均治療3 d。治療結(jié)束后1 h復(fù)查血常規(guī)、血生化、肝腎功能及血?dú)夥治觯涗浹鹾现笖?shù)，再次行支氣管肺泡灌洗，檢測BALF中IL-6和白蛋白濃度。結(jié)果 治療后，治療組癥狀改善優(yōu)于對照組；對照組氧合指數(shù)及支氣管肺泡灌洗液中白蛋白、IL-6前后變化無統(tǒng)計(jì)學(xué)差異，治療組這3項(xiàng)指標(biāo)治療前后變化有明顯統(tǒng)計(jì)學(xué)差異（P＜0.05）。結(jié)論 羥乙基淀粉130/0.4可減輕肺部炎癥，有毛細(xì)血管堵漏作用，對急性呼吸窘迫綜合征有保護(hù)作用。

Objective To study the clinical efficiency of hydroxyethyl starch on acute respiratory distress syndrome induced by trauma. Methods The patients (50 cases) diagnosed as acute respiratory distress syndrome were randomly divided into treatment (25 cases) and control (25 cases) groups. After diagnosis, the blood routine and biochemical, liver and kidney function, and blood gas examination of the two groups were investigated. All patients were given mechanical ventilation, and when positive end expiratory pressure ≥5 cm H2O (1 cm H2O=97.72 Pa) the APACHE II score, sign, and oxygen index were recorded. They were administered with bronchoalveolar lavage, and the bronchoalveolar lavage fluid (BALF) was sent to examine the IL-6 and albumin. Patients in the control group were iv administered with Ringers solution 1 000 mL, once daily. Patients in the treatment group were iv administered with hydroxyethyl starch 130/0.4 1 000 mL, once daily, and the two groups were treated for 3 d. One hour after the treatment, the blood routine and biochemical, liver and kidney function, blood gas examination and oxygen index in the two groups were reviewed. IL-6 and albumin of BALF were examined. Results After the treatment, the symptoms in the treatment group were better than that in the control group. There was no significant difference in oxygen index, IL-6, and albumin of BALF before and after the treatment, while there was significant difference in the three indexes of the treatment group before and after the treatment (P < 0.05). Conclusion Hydroxyethyl starch 130/0.4 could alleviate the degree of lung inflammation and has capillary plugging effect, which has the protective effect on acute respiratory distress syndrome.

寧夏自然科學(xué)基金資助項(xiàng)目（NZ08147）