乌司他丁联合大黄对创伤后急性肺损伤的治疗效果  

Curative Effect of Ulinastatin Combined with Rhubarb in Treatment of Post-traumatic Acute Lung Injury

作　　者：陈子彬 丰浩荣 王祥和 

机构地区：[1]解放军98医院南京军区麻醉与重症治疗中心,浙江湖州313000

出　　处：《解放军医药杂志》2015年第2期69-72,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：南京军区科技创新课题(09MA009);浙江省湖州市科技局自然科学基金(2009YSB20)

摘　　要：目的探讨乌司他丁联合大黄在创伤后急性肺损伤(ALI)中的治疗效果。方法选取2011年2月—2013年12月收治的ALI 84例,按治疗方法分为乌司他丁组、大黄组、联合用药组及对照组,每组21例,4组均给予常规治疗,乌司他丁组给予乌司他丁微泵静脉注射,大黄组给予大黄胶囊鼻饲,联合用药组给予乌司他丁联合大黄治疗。观察治疗前、后呼吸频率、机械通气时间及总住院时间,呼吸相关指标,血白细胞及细胞因子变化。结果 4组共死亡10例,病死率为11.9%。乌司他丁组、大黄组、联合用药组机械通气时间、总住院时间短于对照组,急性呼吸窘迫综合征发生率低于对照组,且联合用药组疗效更显著(P<0.05)。4组治疗后与治疗前比较,呼吸频率减缓,二氧化碳分压、氧和指数增高,白细胞、C反应蛋白、白介素-2、白介素-6、肿瘤坏死因子-α水平明显下降,且均以联合用药组变化最明显(P<0.05)。结论乌司他丁联合大黄治疗ALI具有协同作用,并可抑制炎性因子释放,疗效确切。Objective To investigate the curative effect of Ulinastatin combined with Rhubarb in treatment of post-traumatic acute lung injury（ ALI）. Methods A total of ALI 84 patients admitted during February 2011 and December 2013 were divided into the Ulinastatin group（ n = 21）,the Rhubarb group（ n = 21）,the Ulinastatin combined with Rhubarb group（ n = 21） and the control group（ n = 21）. Based on the conventional treatment,the Ulinastatin group was given Ulinastatin with intravenous injection through a micro pump,and the Rhubarb group received nasal feeding with Rhubarb capsules,while Ulinastatin combined with Rhubarb group was given Ulinastatin combined with Rhubarb treatment. The changes of respiratory rate（ RR）,duration of mechanical ventilation,total hospitalization time,respiratory related indexes,white blood cells（ WBC） count and blood cytokines before and after the treatment in the four groups were observed. Results In the four groups,10 patients died and the fatality rate was 11. 9%. In the Ulinastatin,Rhubarb and combined groups,the duration of mechanical ventilation and hospitalization time were shorter than those in control group,while the incidence rate of acute respiratory distress syndrome（ ARDS） was lower than that in the control group,and the curative effect in the combined group was especially significant（ P〈0. 05）. The slowed RR,increased values of Pa CO2 and Pa O2/ Fi O2,decreased levels of WBC count,C-reactive protein（ CRP）,plasma IL-2（ interleukin）,IL-6and Tumor Necrosis Factor-alpha（ TNF- α） after the treatment were found in the four groups compared with those before the treatment. and the changes in the combined group was the most significant（ P〈0. 05）. Conclusion Ulinastatin combined with Rhubarb in treatment of ALI has the synergetic effect,and it can inhibit the inflammatory cytokine release.

关 键 词：乌司他丁 大黄 创伤和损伤 急性肺损伤 

分 类 号：R641[医药卫生—外科学]