乌司他丁对创伤性休克患者术后呼吸功能及炎性因子的影响  

Early curative effect of ulinastatin in the treatment of systemic inflammatory reaction after traumatic hemorrhagic shock

作　　者：宗媛[1] 王艳[1] 张怡[1] 李博玲[1] 高麦仓[2] 

机构地区：[1]陕西省人民医院重症医学科,西安710068 [2]陕西中医药大学附属医院重症医学科,咸阳712000

出　　处：《陕西医学杂志》2017年第1期96-98,共3页Shaanxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2014JM4140)

摘　　要：目的:探讨术后注射乌司他丁治疗创伤性休克患者的临床疗效。方法:选择创伤性休克手术患者53例,根据术后治疗方案分为治疗组和对照组,对照组27例采用常规糖皮质激素治疗,治疗组26例在对照组基础上给予乌司他丁静注。分析和比较两组术后第1、2、3、5天的呼吸功能,白细胞计数和血清C反应蛋白水平及住院时间。结果:两组术后第1、2、3、5天PaO_2/FiO_2比值、FIO_2及白细胞计数比较均无统计学差异(P>0.05),但治疗组术后第5天动脉血氧饱和度显著高于对照组(P<0.01),术后第1天血清C反应蛋白水平为(5.7±0.6)μg/ml,术后第2天血清C反应蛋白水平为(14.3±1.1)μg/ml,均显著低于对照组,差异具有统计学意义(P<0.01)。两组术后机械辅助呼吸时间、ICU滞留时间、住院时间比较,治疗组显著少于对照组(P<0.05)。结论:创伤性休克患者术后早期注射乌司他丁有益于抑制术后全身炎症反应,改善患者呼吸功能。Objective ：To evaluate the early curative effect of ulinastatin in the treatment of systemic inflammatory reaction after traumatic hemorrhagic shock .Methods ：53 cases of traumatic shock operation were divided into treatment group （26 cases） and control group （27 cases） .The control group was given conventional glucocorticoid therapy ,26 cases in the treatment group were given Ulinastatin intravenous injection on the basis of the control group .Respiratory function index of 1 ,2 ,3 and 5 days after operation were analyzed and compared .The incidence of postoperative complications ,white blood cell count and serum C reactive protein level and medical cost were compared .Results ：The clinical characteristics of the two groups were no differences between the groups （P 〉 0 .05） . The postoperative oxygenation （PaO2 /FiO2 ratio） did not differ between the groups（P〉 0 .05） ,but the decrease in oxygen saturation （SpO2 ） was significantly inhibited in the treatment group compared with the control group （P〈 0 . 01） .A significant inhibition of the increase in the CRP level also occurred in the treatment group （P〈 0 .01） .The patients in the treatment group were also hospitalized for shorter periods compared to those in the control group . The duration of mechanical ventilation ,ICU retention time and hospital stay of the treatment group were significantly less than that of the control group （P〈 0 .05） ,the total cost of the treatment group was significantly lower than that of the control group （P〈 0 .05） .Conclusion ：The early administration of ulinastatin to patients receiving surgery for trauma hemorrhagic shock can inhibit postoperative systemic inflammatory reactions and it might also have a beneficial effect on the prognosis .

关 键 词：休克  创伤性/并发症 脓毒症综合征/病因学 脓毒症综合征/药物疗法 糖蛋白类/治疗应用 手术后期间 @乌司他丁 

分 类 号：R641[医药卫生—外科学]