ABSTRACT
Objective To investigate the clinical effect of Shenfu injection in the treatment of patients with post - cardiac arrest syndrome(PCAS),to analyze the patients' blood C - reactive protein (CRP) and early mean arterial pressure. Methods From September 2013 to September 2016,80 patients with PCAS in the No. 98 Hospital of PLA were randomly divided into study group and control group according to the digital table,with 40 cases in each group. The study group was treated by Shenfu injection,the control group was treated by saline. The changes of CRP,mean arterial pressure and GCS score at 4h,12h,1d,2d and 3d after resuscitation and the 90d survival rate were observed. Results At 4h,12h,1d,2d and 3d after resuscitation,the peripheral blood CRP levels in the study group were (22. 01 ±2. 16)mg/ L,(34. 68 ± 4. 95)mg/ L,(62. 51 ± 3. 68)mg/ L,(98. 65 ± 6. 57)mg/ L,(100. 67 ± 10. 03)mg/ L, respectively,which in the control group were (25. 16 ± 3. 54)mg/ L,(41. 52 ± 5. 31)mg/ L,(75. 09 ± 4. 58)mg/ L, (120. 48 ± 10. 61)mg/ L,(128. 26 ± 9. 64)mg/ L,respectively,there were statistically significant differences between the two groups(t = 4. 804,5. 959,13. 542,11. 063,12. 543,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscita-tion,the mean arterial pressure in the study group were (78. 03 ± 8. 65)mmHg,(88. 34 ± 10. 20)mmHg,(97. 05 ± 9. 57)mmHg,(105. 29 ± 10. 45)mmHg,(112. 14 ± 9. 46) mmHg,respectively,which were higher than those in the control group [(68. 21 ± 8. 03)mmHg,(74. 01 ± 10. 59) mmHg,(83. 09 ± 11. 25) mmHg,(98. 25 ± 9. 17) mmHg, (104. 68 ± 3. 14)mmHg](t = 5. 262,6. 164,5. 978,3. 203,4. 733,all P < 0. 01). At 4h,12h,1d,2d and 3d after resuscitation,the GCS scores of the study group were (5. 21 ± 1. 12) points, (5. 78 ± 2. 05) points, (6. 85 ± 1. 68)points,(7. 91 ± 2. 57)points,(9. 98 ± 2. 07) points,respectively,which were higher than those of the control group [(4. 01 ± 2. 14) points, (4. 22 ± 3. 75) points, (4. 39 ± 3. 89) points, (4. 41 ± 2. 86) points, (5. 06 ± 4. 14)points](t = 3. 142,2. 309,3. 672,5. 757,6. 723,all P < 0. 05). The survival rate of the study group was 50％(20 / 40) at 90d after resuscitation,which was higher than that of the control group [23％ (9 / 40)](χ2 = 6. 545,P =0. 011). Conclusion Shenfu injection has protective effect on the function of patients with CRP after surgery,and can improve the prognosis of patients,it is worthy of clinical use.
ABSTRACT
Objective To evaluate the clinical effect of the chest orthosis on patients with multiple rib or(and) sternal fracture in early period of closed chest trauma.Methods Patients with multiple fractured of ribs or (and) sternal fracture were divided into control group (n =16)treated with the traditional fixation methods ( thoracic girdle added with folding towels) and experimental group ( n =30 ) treated with chest orthosis between January 2009 and December 2011.Correlated parameters of these patients in the two groups,including pain,indexes of blood gas analysis,pulmonary complications and hospitalization time were evaluated.Results There were significant differences on visual analogue scale(VAS) [ (4.45 ±2.23) vs (8.15 ±2.02),t =2.921,P ＜0.01 ],blood gas analysis including PaO2 [ 88.16 ± 9.12) mm Hg vs (77.22 ± 6.24 ) mm Hg,t =2.413,P ＜0.05] andPaCO2[ (40.91 ±3.40)mm Hg vs (46.06 ±5.40)mm Hg,t =2.335,P＜0.05] between experimental group and control group.The incidence rate of pulmonary complications in experimental group was significantly lower than that in control group [ 17％ ( 5/30 ) vs 44％ ( 7/16 ),x2 =23.478,P ＜ 0.05 ].And hospitalization time in experimental group was significantly shorter compared with control group[ (7.26 ± 4.17) d vs ( 14.26 ±3.53)d,t =2.430,P ＜0.05].Conclusion The chest orthosis in early treatment of chest trauma can reduce the pain and improve the condition of patients,and it is a simple,effective and cheap method with significant clinical effect.
ABSTRACT
Objective To explore a rapid,simple and effective therapy for serious pneumothorax which could be used in pre-hospital and in-hospital first-aid.Methods Sixty-seven patients were randomly divided into the observation group and control group .Patients in the observation group were treated using laparoscopic trocar for rapidly closed thoracic drainage,and patients in the control group were treated by using the traditional large caliber drainage tube and the intercostal incision method of conventional closed thoracic drainage.The operation time,remaining time of drainage,length of stay,effective rate,and complications,including of postoperative pain,hemorrhage,subcutaneous emphysema and infection were observed in both groups. Results The total effective rate was 94.1%(32/34) in the observation group,which was significantly higher than that in the control group(90.9%,30/33)(x2=1.876,P＞0.05).No significant difference was found on the remaining time of drainage and length of stay between the two groups(remaining time of drainage:[4.56±1.65]d vs.[6.26±3.45]d;length of stay:(6.0±2.6)d vs.(6.7±2.2)d ,t=1.335 and 0.779,respectively,Ps＞0.05).The operation time of using laparoscopic trocar was significantly lower than that of the control group((5.00±1.28)min vs.(15.00±4.03)min,t=3.031,P＜0.05).The incision length was(0.95±0.11)cm in the observational group,which was significantly lower than that in the control group((2.41±0.52)cm ,t=2.585,P＜0.05).Postoperative pain occurred in 14.7%(5/34) of patients in the observational group,which was significantly lower than that in the control group(87.9%(29/33))(t=2.983,P＜0.05).In the observational group no hemorrhage and infection occurred,whereas in the control group the hemorrhage and infection rate was 36%(12/33) and 33%(11/33),respectively(x2=5.880 and 3.687,respectively,Ps＜0.05). Conclusion The use of laparoscopic trocar for rapidly closed thoracic drainage in the treatment of serious pneu-mothorax is simple,easy,convenient,effective and reliable,with few complications.This therapy is suitable for using in pre-hospital and in-hospital first-aid.