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目的观察大剂量与常规剂量乌司他丁治疗感染性休克(IS)的临床效果。方法选取医院收治的IS患者78例,将其平均分为研究组和对照组,每组39例。对照组采用乌司他丁20万U缓慢静推治疗,研究组采用乌司他丁100万U缓慢静推治疗。观察2组患者治疗前后呼吸、心率、体温、超敏C反应蛋白(hs-CRP)与白细胞水平,比较2组多器官功能障碍综合征(MODS)的发生率和不良反应发生情况。结果经相应治疗后,研究组呼吸、心率、hs-CRP水平与白细胞均低于对照组(P<0.05),体温对比差异无统计学意义(P>0.05)。研究组治疗期间发生MODS发生率为25.64%显著低于对照组的56.41%(P<0.01)。2组治疗期间均未见明显的药物不良反应。结论大剂量乌司他丁治疗IS患者的疗效优于常规剂量组,可有效抑制炎性因子释放,维持生命体征平稳,降低MODS概率,安全可靠,适于临床应用。
Objective To observe the clinical effect of high-dose and conventional doses of ulinastatin in the treatment of septic shock (IS). Methods Seventy-eight patients with IS who were admitted to hospital were divided equally into study group and control group, with 39 cases in each group. The control group with 200,000 U ulinastatin U slow push therapy, the study group with ulinastatin 1 million U slow push therapy. The respiratory rate, heart rate, body temperature, hs-CRP and leukocyte levels in two groups were observed before and after treatment. The incidence of multiple organ dysfunction syndrome (MODS) and the incidence of adverse reactions in the two groups were compared. Results After treatment, the levels of respiration, heart rate, hs-CRP and leukocytes in the study group were lower than those in the control group (P <0.05). There was no significant difference in body temperature between the two groups (P> 0.05). The occurrence rate of MODS in study group was significantly lower than that in control group (25.64% vs 56.41%, P <0.01). No significant adverse drug reactions were observed during the two groups. Conclusion The efficacy of high-dose ulinastatin in patients with IS is better than that of conventional dose group, which can effectively suppress the release of inflammatory factors, maintain the stable vital signs and reduce the probability of MODS. It is safe and reliable and is suitable for clinical application.