大剂量乌司他丁治疗脓毒性休克的临床疗效分析  

Clinical Effect of High-Dose Ulinastatin in the Treatment of Sepsis Shock

作　　者：曾超[1] 龚勋[1] 钟建华[1] 刘璐 姚玲[1] Zeng Chao;Gong Xun;Zhong Jianhua;Liu Lu;Yao Ling(Department of Intensive Care Unit,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang,443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]重症医学科,湖北宜昌443003

出　　处：《巴楚医学》2023年第3期96-99,共4页Bachu Medical Journal

基　　金：湖北省卫生计生委科研项目(No:WJ2019M062)。

摘　　要：目的:探讨大剂量乌司他丁治疗脓毒性休克的临床疗效。方法:选取2020年6月-2021年4月在宜昌市中心人民医院治疗的60例脓毒性休克患者,随机分为3组:对照组(A组20例)、常规剂量组(B组20例)、大剂量组(C组20例)。A组按脓毒症治疗指南进行治疗;B组在A组治疗基础上加用常规剂量乌司他丁治疗7天;C组在A组治疗基础上加用大剂量乌司他丁治疗7天。分别在治疗开始及7天后检测血清肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、C-反应蛋白(CRP)、降钙素原(PCT);并记录治疗后机械通气时间及血管活性药物使用时间。结果:C组炎症因子较A组及B组明显降低,差异均有统计学意义(均P<0.05)。C组机械通气时间与血管活性药物使用时间较A组及B组少,差异均有统计学意义(均P<0.05)。结论:大剂量乌司他丁治疗脓毒性休克,可以更有效降低炎症因子水平,缩短机械通气时间及血管活性药物使用时间。Objective:To investigate the clinical efficacy of high-dose ulinastatin in the treatment of sepsis shock.Methods:A total of 60 patients with sepsis shock from June,2020 to April,2021 in Yichang Central People's Hospital were randomly divided into three groups,including the control group(Group A),the conventional dose group(Group B),and high-dose group(Group C),with 20 cases in each group.Patients in Group A were treated according to the sepsis treatment guidelines.Patients in Group B and Group C were given conventional and high dose of ulinastatin for 7 days on the basis of Group A,respectively.The levels of tumor necrosis factorα(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein(CRP)and procalcitonin(PCT)were detected at the beginning of treatment and 7 days later.The time of mechanical ventilation and vasoactive drugs using were compared.Results:The levels of inflammatory factors in Group C were significantly lower than those in Group A and Group B(both P<0.05).The time of mechanical ventilation and the vasoactive drugs using in Group C were decreased,when compared with Group A and Group B,with statistically significant differences(both P<0.05).Conclusion:High-dose ulinastatin in the treatment of sepsis shock can reduce the level of inflammatory factors,shorten the time of mechanical ventilation and vasoactive drugs using.

关 键 词：脓毒性休克 乌司他丁 机械通气 血管活性药物 

分 类 号：R631[医药卫生—外科学]