Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Surg Today. 2010 Nov;40(11):1034-9. doi: 10.1007/s00595-010-4296-y. Epub 2010 Nov 3.
To clarify the clinical significance of sivelestat sodium (SIV) administration, we surveyed the status of 40 patients treated with SIV for respiratory dysfunction following surgery.
The subjects were patients who received SIV administration due to systemic inflammatory response syndrome (SIRS) and respiratory dysfunction (PaO(2)/F(I)O(2) ratio ≤300 mmHg) after surgery at the Department of Surgery and Science, Kyushu University, and related facilities between April and December 2008.
The most frequent underlying condition was perforation of the digestive tract, followed by cancer of the upper digestive organs. The main causes of SIRS were surgical stress and infection. The mean P/F ratio at the initiation of SIV administration was 185.5 ± 72.0 mmHg. The ratio increased, and the number of SIRS-related factors decreased with time after SIV administration. Sivelestat sodium was administered within 24 h after the onset of respiratory dysfunction in 87.5% of the patients, and the survival rate at 28 days after the initiation of SIV administration was 90.0%.
Our findings suggest that multidisciplinary postoperative management, including the administration of SIV, during the early phase after the onset of respiratory dysfunction leads to improvements in respiratory function and survival.
为了阐明西维来司他钠(SIV)给药的临床意义,我们调查了 40 例因术后全身炎症反应综合征(SIRS)和呼吸功能障碍(PaO2/FIO2 比≤300mmHg)而接受 SIV 治疗的患者的状况。
这些患者是 2008 年 4 月至 12 月期间在九州大学外科和科学系及相关机构因手术而接受 SIV 给药的患者,其存在 SIRS 和呼吸功能障碍(PaO2/FIO2 比≤300mmHg)。
最常见的基础疾病是消化道穿孔,其次是上消化道癌症。SIRS 的主要原因是手术应激和感染。SIV 给药开始时的平均 P/F 比为 185.5±72.0mmHg。随着时间的推移,P/F 比增加,SIRS 相关因素的数量减少。87.5%的患者在呼吸功能障碍发作后 24 小时内给予 SIV,SIV 给药开始后 28 天的存活率为 90.0%。
我们的研究结果表明,在呼吸功能障碍发作后的早期阶段,多学科的术后管理,包括 SIV 的给药,可以改善呼吸功能和生存率。