乌司他丁联合地塞米松治疗创伤性肺损伤时对患者动脉血气氧交换指标和血清超敏C-反应蛋白浓度的影响  

Influence of ulinastatin in combination with dexamethasone on arterial blood gas oxygen exchange index and serum hypersensitive C-reactive protein concentration in the treatment of traumatic patients with lung

作　　者：蔡艳[1] 

机构地区：[1]辽宁中医药大学附属医院,沈阳110032

出　　处：《实用药物与临床》2015年第3期280-283,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察乌司他丁联合地塞米松治疗创伤性肺损伤时对患者动脉血气氧交换指标和血清超敏C-反应蛋白(CRP)浓度的影响。方法选取我院2013年1月至2014年1月收治的64例创伤所致肺损伤住院患者,将患者随机分为观察组与对照组,每组32例,对照组在常规治疗基础上接受地塞米松治疗,观察组在对照组治疗基础上联合乌司他丁治疗。记录并比较两组患者机械通气使用率、呼吸窘迫综合征(ARDS)发生率,检测患者不同时间肺泡气动脉血氧分压、氧和分数、动脉氧分压与患者血清CRP浓度。结果治疗后,两组患者氧交换指标显著改善(P<0.05),CRP浓度降低(P<0.05),而观察组患者治疗后CRP浓度改善程度明显优于对照组(P<0.05),观察组患者ARDS发生率以及机械通气使用率显著低于对照组(P<0.05)。结论乌司他丁联合地塞米松治疗创伤性肺损伤疗效显著,能够有效改善患者氧合状况,降低患者炎症反应发生率以及机械通气使用率。Objective To investigate the combined effects of ulinastatin and dexamethasone on arterial blood gas index and C-reactive protein（ CRP） level in patients with traumatic lung injury. Methods 64 patients with traumatic lung injury admitted to our hospital from January 2013 to January 2014 were randomly divided into observation group and control group（ 32 patients in each group）. Patients in control group received extra dexamethasone on the basis of traditional treatment while patients in observation group received treatment by combining ulinastatin and dexamethasone besides the traditional treatment. Mechanical ventilation rate and incidence rate of acute respiratory distress syndrome（ ARDS） were recorded and compared between the two groups and the relationship between alveolar arterial oxygen partial pressure,oxygenation level,arterial oxygen partial pressure at different time points and serum CRP level was analyzed. Results The blood-oxygen transfer indexes were significantly improved（P〈0. 05） and CRP level significantly reduced（P〈0. 05） after treatment in the two groups,and the CRP in observation group reduced more significantly than that in control group（P〈0. 05）,the incidence rate of ARDS and mechanical ventilation rate in observation group was lower than those in control group（P〈0. 05）. Conclusion Combination of ulinastatin and dexamethasone in the treatment of traumatic lung injury can significantly improve outcomes and patient＇s oxygenation status,thus reduce incidence rate of inflammation and utilization rate of mechanical ventilation.

关 键 词：机械通气 超敏C反应蛋白 乌司他丁 地塞米松 

分 类 号：R563.8[医药卫生—呼吸系统]