乌司他丁联合小剂量精氨酸加压素治疗严重肺挫伤的随机对照试验  

Clinical Efficacy of Ulinastatin Combined with Low-dose Arginine Vasopressin for Severe Pulmonary Contusion:A Randomized Controlled Trial

作　　者：林洪胜[1] 李健球[2] 杜晓阳 

机构地区：[1]广州医科大学附属深圳沙井医院胸外科,广东深圳518104 [2]广州医科大学附属深圳沙井医院ICU,广东深圳518104

出　　处：《中国胸心血管外科临床杂志》2015年第8期760-764,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：2012年宝安区科技计划项目(2012156)~~

摘　　要：目的观察乌司他丁联合小剂量精氨酸加压素治疗严重肺挫伤的临床疗效。方法 2012年4月到2014年6月将我院60例严重肺挫伤患者按随机数字表法分成3组,即常规治疗组(A组,n=20),乌司他丁治疗组(B组,n=20)和联合用药治疗组(C组,n=20),比较3组临床指标和实验室指标差异。结果 C组患者治疗后7 d相比治疗前,呼吸频率(RR)、白细胞介素-6(IL-6)、IL-8降低,差异有统计学意义(P=0.000,0.000,0.000);氧合指数(Pa O2/Fi O2)、二氧化碳分压(Pa CO2)提高,差异有统计学意义(P=0.000,0.000)。治疗7 d后,B组与A组相比,RR、IL-6、IL-8显著降低,差异有统计学意义(P=0.000,0.043,0.000);氧合指数(Pa O2/Fi O2)、二氧化碳分压(Pa CO2)和胸部X线片评分值显著提高,差异有统计学意义(P=0.010,0.000,0.000);C组与B组比较,RR、IL-6、IL-8下降,差异有统计学意义(P=0.000,0.045,0.000);Pa O2/Fi O2、Pa CO2和胸部X线片评分上升程度明显,差异有统计学意义(P=0.043,0.010,0.001)。结论乌司他丁联合小剂量精氨酸加压素治疗严重肺挫伤有治疗效果,同时比常规治疗与乌司他丁治疗效果更明显。Objective To observe the clinical efficacy of ulinastatin combined with low-dose arginine vasopressin in treating severe pulmonary contusion.Method Sixty patients with severe pulmonary contusion were enrolled in our hospital between April 2012 to June 2014 year.All the patients were randomly divided into three groups.They were respectively defined as a routine treatment group(group A,n=20),an ulinastatin treatment group(group B,n=20),and a combined treatment group(group C,n=20).The respiratory frequency(RR),oxygenation index,partial pressure of carbon dioxide(PaCO_2),the change of chest X-ray and the change of serum interleukin-6(IL-6),IL-8 levels were compared among three groups before and after therapy.Result The respiration frequency(RR) and the concentration of serum IL-6,IL-8 levels were decreased in the group C before and after treatment with statistical differences(P=0.000,0.000,0.000).PaO_2 /FiO_2 and PaCO_2 were significantly increased in the group C before and after treatment(P=0.000,0.000).After treatment for 7 d,the respiration frequency(RR) and the concentration of serum IL-6,IL-8 of patients in the group B decreased significantly compared with those in the group A(P=0.000,0.043,0.000).While PaO_2 /FiO_2,PaCO_2 and the score of chest X-ray increased significantly in the group B(P=0.010,0.000,0.000).Compared with those in the group B,RR and the concentration of serum IL-6,IL-8 of patients in the group C decreased significantly(P=0.000,0.045,0.000),while PaO_2/FiO_2,PaCO_2 and the score of chest X-ray increased significantly(P=0.043,0.010,0.001).Conclusion Ulinastatin combined with low-dose arginine vasopressin shows obvious effects in the patients with severe pulmonary contusion.And its therapeutical effects are better than that of the other two treatment options.

关 键 词：严重肺挫伤 乌司他丁 精氨酸加压素 联合用药 

分 类 号：R655.3[医药卫生—外科学]