乌司他丁联合俯卧位通气对急性呼吸窘迫综合征患者预后的影响  

Effects of Ulinastatin Combined With Prone Position Ventilation on the Prognosis in Patients with Acute Respiratory Distress Syndrome

作　　者：孔祥伟[1] 梁朝矿 黄承吨 邓镇锋 KONG Xiang-Wei;LIANG Chao-Kuang;HUANG Cheng-Dun;DENG Zhen-Feng(Department of Respiratory and Critical Medicine,Huaiji County People's Hospital,Zhaoqing 526400,China)

机构地区：[1]广东省怀集县人民医院呼吸与危重症医学科,广东肇庆526400

出　　处：《中国药物经济学》2020年第4期82-84,88,共4页China Journal of Pharmaceutical Economics

摘　　要：目的探讨乌司他丁联合俯卧位通气对急性呼吸窘迫综合征患者预后的影响。方法选取2016年1月至2019年3月于广东省怀集县人民医院呼吸与危重症医学科接受治疗的71例急性呼吸窘迫综合征患者作为研究对象,根据治疗方式不同分为观察组(乌司他丁+俯卧位通气+常规治疗,39例)和对照组(常规治疗+俯卧位通气,32例)。比较两组患者治疗前后炎症介质水平、呼吸动力学指标变化情况及治疗后不良事件发生情况。结果治疗后,两组白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平低于治疗前,且观察组IL-6及TNF-α水平低于对照组,差异有统计学意义(P<0.05);两组动脉血氧分压(PaO2)高于治疗前,吸入气中的氧浓度分数(FiO2)及呼气末正压通气水平(PEEP)低于治疗前,且观察组PaO2高于对照组,FiO2及PEEP低于对照组,差异有统计学意义(P<0.05);观察组不良事件发生率为5.13%,低于对照组的28.13%,差异有统计学意义(P<0.05)。结论对急性呼吸窘迫综合征患者使用乌司他丁联合俯卧位通气治疗,可有效降低炎性介质水平,改善呼吸动力学,降低不良事件发生率,治疗效果较好。Objective To investigate the curative effects of ulinastatin combined with prone position ventilation in patients with acute respiratory distress syndrome(ARDS).Methods A total of 71 patients with ARDS who treated in the Department of Respiratory and Critical Medicine,Huaiji County People's Hospital,from January 2016 to March 2019 were retrospectively analyzed.and were divided into an observation group(ulinastatin+prone position ventilation+routine treatment,39 cases)and a control group(routine treatment+prone position ventilation,32 cases)according to treatment methods.The levels of inflammatory factors,changes of pneumodynamics indexes and the incidence of adverse events after treatment were compared between 2 groups.Results After treatment,the levels of interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in 2 groups were lower than those before treatment,and the IL-6 and TNF-αlevels in observation group were lower than those in control group,and the differences are statistically significant(P<0.05);the arterial partial pressure of oxygen(PaO2)of 2 groups was higher than that before treatment,and the fraction of inspired oxygen(FiO2)and positive end expiratory pressure(PEEP)in 2 groups were lower than those before treatment.The PaO2 in observation group was higher than that in control group.The FiO2 and PEEP in observation group were lower than those in control group and the differences are statistically significant(P<0.05);The incidence of adverse events in observation group(5.13%)was lower than that in control group(28.13%)and the differences are statistically significant(P<0.05).Conclusion Ulinastatin combined with prone position ventilation in treatment of patients with ARDS can decrease the levels of inflammatory factors,improve pneumodynamics,decrease the incidence of adverse events,and have better curative effects.

关 键 词：急性呼吸窘迫综合征 乌司他丁 俯卧位通气 炎症介质 呼吸动力学 

分 类 号：R563.9[医药卫生—呼吸系统] R974[医药卫生—内科学]