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目的观察乌司他丁联合小剂量精氨酸加压素治疗严重肺挫伤的临床疗效。方法 2012年4月到2014年6月将我院60例严重肺挫伤患者按随机数字表法分成3组,即常规治疗组(A组,n=20),乌司他丁治疗组(B组,n=20)和联合用药治疗组(C组,n=20),比较3组临床指标和实验室指标差异。结果 C组患者治疗后7 d相比治疗前,呼吸频率(RR)、白细胞介素-6(IL-6)、IL-8降低,差异有统计学意义(P=0.000,0.000,0.000);氧合指数(Pa O2/Fi O2)、二氧化碳分压(Pa CO2)提高,差异有统计学意义(P=0.000,0.000)。治疗7 d后,B组与A组相比,RR、IL-6、IL-8显著降低,差异有统计学意义(P=0.000,0.043,0.000);氧合指数(Pa O2/Fi O2)、二氧化碳分压(Pa CO2)和胸部X线片评分值显著提高,差异有统计学意义(P=0.010,0.000,0.000);C组与B组比较,RR、IL-6、IL-8下降,差异有统计学意义(P=0.000,0.045,0.000);Pa O2/Fi O2、Pa CO2和胸部X线片评分上升程度明显,差异有统计学意义(P=0.043,0.010,0.001)。结论乌司他丁联合小剂量精氨酸加压素治疗严重肺挫伤有治疗效果,同时比常规治疗与乌司他丁治疗效果更明显。
Objective To observe the clinical efficacy of ulinastatin combined with low dose arginine vasopressin in the treatment of severe pulmonary contusion. Methods From April 2012 to June 2014, 60 patients with severe pulmonary contusion in our hospital were divided into three groups according to random number table: conventional treatment group (group A, n = 20), ulinastatin treatment group (group B) , n = 20) and combination therapy group (group C, n = 20). The differences of clinical and laboratory indexes between the three groups were compared. Results The respiratory rate (RR), interleukin - 6 (IL - 6) and IL - 8 in group C were significantly lower than those before treatment at 7 days after treatment (P = 0.000,0.000,0.000). Oxygenation index (Pa O2 / Fi O2), carbon dioxide partial pressure (Pa CO2) increased, the difference was statistically significant (P = 0.000,0.000). After 7 days of treatment, the levels of RR, IL-6 and IL-8 in group B were significantly lower than those in group A (P = 0.000,0.043,0.000); the oxygenation index (Pa O2 / Fi O2) (P = 0.010,0.000,0.000). Compared with group B, the levels of RR, IL-6 and IL-8 in group C were significantly lower than those in group B (P = 0.000,0.045,0.000). The Pa O2 / Fi O2, Pa CO2 and chest X-ray scores increased significantly, the difference was statistically significant (P = 0.043,0.010,0.001). Conclusion Ulinastatin combined with low-dose arginine vasopressin has a significant therapeutic effect on severe pulmonary contusion. At the same time, the effect of ulinastatin is better than that of ulinastatin.