乌司他丁对急诊脓毒性休克患者肺毛细血管通透性和复苏效果的影响  

Effect of Ulinastatin on pulmonary capillary permeability and resuscitation in patients with emergency septic shock

作　　者：周茜 ZHOU Qian(Emergency Department of Changsha Central Hospital, Changsha City, Hunan 410004, China)

机构地区：[1]长沙市中心医院急诊科

出　　处：《临床合理用药杂志》2019年第23期7-8,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察乌司他丁对急诊脓毒性休克患者肺毛细血管通透性和复苏效果的影响。方法选择医院收治的急诊脓毒性休克患者100例,随机分为观察组和对照组,每组50例。对照组给予抗感染、机械通气、液体复苏等治疗,观察组在对照组治疗基础上给予乌司他丁治疗,比较2组用药前后的血流动力学相关参数、炎性指标、氧合作用、乳酸及复苏液体的用量、血管使用的活性药物量。结果治疗后,2组肺血管的通透性指数、血管外肺水指数、中心静脉压的数值比较,差异均有统计学意义(P <0. 01),而心输出量及外周血管的阻力指数比较差异均无统计学意义(P> 0. 05)。观察组晶体液的总量、胶体液的总量、白蛋白含量及血管活性药物的使用情况均优于对照组(P <0. 01);观察组氧合作用、乳酸、C-反应蛋白及降钙素原水平均低于对照组(P <0. 01)。结论乌司他丁可改善组织的氧合作用及循环灌注,减少复苏胶体的需要量,提高患者复苏的质量及效果。Objective To observe the effect of ulinastatin on pulmonary capillary permeability and resuscitation in patients with emergency septic shock. Methods One hundred patients with emergency septic shock were randomly divided into observation group and control group,with 50 cases in each group. The control group received conventional treatments such as anti-infection,mechanical ventilation,and fluid resuscitation,and the observation group was treated with ulinastatin on the basis of the control group. Hemodynamic parameters,inflammatory markers,oxygenation,the amount of lactic acid and resuscitation fluid,and the amount of vasoactive drugs used in the two groups were compared. Results After treatment,the pulmonary vascular permeability index,extravascular lung water index,and central venous pressure were significantly different between the two groups( P < 0. 01). There was no significant difference in cardiac output and peripheral vascular resistance index between the two groups( P > 0. 05). The total amount of crystalloid,the total amount of colloidal fluid,the albumin content and the use of vasoactive drugs in the observation group were better than those in the control group( P < 0. 01). The oxygenation,lactic acid,C-reactive protein and procalcitonin levels in the observation group were lower than those in the control group( P < 0. 01). Conclusion Ulinastatin can improve tissue oxygenation and circulatory perfusion,reduce the need for resuscitation colloids,and improve the quality and effectiveness of patient resuscitation.

关 键 词：乌司他丁 急诊 脓毒性休克 肺毛细血管 通透性 复苏效果 

分 类 号：R459.7[医药卫生—急诊医学]