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目的:观察乌司他丁(UTI)对急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床应用。方法:选择我院ICU自2008年1月至2011年1月收治的160例ARDS患者作为研究对象,采用随机对照的方法,并且经患者或患者家属知情并签字同意分组。分为UTI组(A组)和对照组(B组)。两组均给予相同综合治疗措施,A组除综合治疗外还给予注射用乌司他丁,每次30万U,每日2次。分别记录两组患者开始治疗、治疗后第3天、治疗第7天的生命体征,动脉血气分析、血生化检查结果、并且记录患者在ICU治疗的转归,应用SPSS13.0软件对结果进行统计学分析。结果:经治疗3天A组呼吸频率低于B组,动脉血气分析提示两组PO2、PO2/FiO2、SaO2均有上升。比较后发现A组PO2、PO2/FiO2、SaO2高于B组(P<0.05),两组PO2、SaO2比较有统计学差异。经治疗3天A组与B组生化指标比较、白细胞计数、肾功及血乳酸均有下降,有统计学差异,P<0.05。全部治疗结束后A组与B组死亡率比较(UTI组34.29%,对照组38.26%,P=0.0097)及机械通气时间比较(UTI组7.54±3.27天,对照组11.78±2.69天,P=0.0086),均有统计学差异。结论:大剂量UTI用于ARDS的临床治疗可有效改善患者氧合指数,减少机械通气时间,降低患者的病死率。
Objective: To observe the clinical effect of ulinastatin (UTI) on acute respiratory distress syndrome (ARDS). Methods: A total of 160 patients with ARDS who were admitted to our hospital from January 2008 to January 2011 were selected as randomized controlled patients and were informed by the patients or their relatives and signed to agree. Divided into UTI group (A group) and control group (B group). Both groups were given the same comprehensive treatment measures, A group in addition to the comprehensive treatment given to injection of ulinastatin, each 300,000 U, 2 times a day. The two groups of patients were started treatment, the first three days after treatment, the seventh day of treatment of vital signs, arterial blood gas analysis, blood biochemical test results, and record the outcome of patients in the ICU treatment, the application SPSS13.0 software statistics Analysis. Results: After 3 days of treatment, the respiratory rate of group A was lower than that of group B. Arterial blood gas analysis indicated that both PO2, PO2 / FiO2 and SaO2 increased. Compared with group B, PO2, PO2 / FiO2 and SaO2 in group A were higher than those in group B (P <0.05). PO2 and SaO2 in the two groups were statistically different. After 3 days of treatment, the white blood cell count, renal function and blood lactic acid in both group A and group B were decreased, with statistical difference (P <0.05). The mortality of group A and group B after the completion of the treatment was 34.29% in the UTI group and 38.26% in the control group, P = 0.0097 and 7.54 ± 3.27 days in the UTI group and 11.78 ± 2.69 days in the control group, P = 0.0086 ), There are statistical differences. Conclusion: The high dose UTI used in the clinical treatment of ARDS can effectively improve the oxygenation index of patients, reduce the mechanical ventilation time and reduce the mortality of patients.