乌司他丁联合HFNC对重症肺炎伴ARDS患者的治疗效果  

Effect of Ulinastatin combined with HFNC in the Treatment of Severe Pneumonia and ARDS

作　　者：纪成意 郑夏云 陈秋燕 JI Chengyi;ZHENG Xiayun;CHEN Qiuyan(Xiamen Third Hospital,Xiamen 361100,China;不详)

机构地区：[1]厦门市第三医院,福建厦门361100

出　　处：《中外医学研究》2024年第30期34-37,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨乌司他丁联合高流量鼻导管氧疗(HFNC)对重症肺炎伴急性呼吸窘迫综合征(ARDS)患者的治疗效果。方法:选取2022年1月—2023年10月在厦门市第三医院确诊的98例重症肺炎伴ARDS患者作为研究对象,根据治疗方案分为A组(n=51,乌司他丁联合HFNC治疗)和B组(n=47,NFNC治疗)。两组均持续治疗7 d,比较两组氧合状态[动脉氧分压(PaO2)、动脉二氧化碳分压(PaCO_(2))、氧合指数(PaO2/FiO2)、pH值]、血流动力学[心率(HR)、平均动脉压(MAP)]及炎症因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平。观察两组不良反应发生情况。结果:治疗后,两组PaO2、PaO2/FiO2、pH均较治疗前升高,且A组高于B组,两组PaCO_(2)均较治疗前降低,且A组低于B组,差异有统计学意义(P<0.05)。治疗后,两组MAP均较治疗前升高,HR均较治疗前降低,差异有统计学意义(P<0.05)。治疗后,两组炎症因子水平均较治疗前降低,且A组低于B组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:乌司他丁联合HFNC可有效进一步降低炎症因子水平,改善患者氧合状态,稳定患者血流动力学,提高临床疗效,具有安全性。Objective:To explore the effects of Ulinastatin combined with high flow nasal cannula(HFNC)on patients with severe pneumonia and acute respiratory distress syndrome(ARDS).Method:98 patients with severe pneumonia and ARDS diagnosed in Xiamen Third Hospital from January 2022 to October 2023 were selected as the study objects,and were divided into group A(n=51 cases,Ulinastatin combined with HFNC treatment)and group B(n=47,NFNC treatment)according to the different treatment options.Both groups were treated continuously for 7 days.The oxygenation status(PaO2,PaCO_(2),PaO2/FiO2,pH value),hemodynamics[heart rate(HR),mean arterial pressure(MAP)]and inflammatory factorsC-reactive protein(CRP),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)were compared between the two groups.The occurrence of adverse reactions in the two groups was observed.Result:After treatment,PaO2,PaO2/FiO2 and pH in both groups were higher than before treatment,and group A was higher than group B,PaCO_(2) in both groups was lower than before treatment,and group A was lower than group B,the difference was statistically significant(P<0.05).After treatment,MAP was higher and HR was lower in both groups than before treatment,the difference was statistically significant(P<0.05).After treatment,the levels of inflammatory factors in both groups were lower than before treatment,and group A was lower than group B,with statistical significance(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Ulinastatin combined with HFNC can effectively further reduce the level of inflammatory factors,improve the oxygenation status of patients,stabilize the hemodynamics of patients,improve clinical efficacy,and have safety.

关 键 词：乌司他丁 高流量鼻导管氧疗 重症肺炎 急性呼吸窘迫综合征 氧合状态 血流动力学 

分 类 号：R563.1[医药卫生—呼吸系统] R563.8[医药卫生—内科学]