急性肺损伤行肺保护性通气加乌司他丁静滴的临床效果

The clinical result of the lung protective ventilation and Ulinastatin intravenous for Acute lung injury(ALI)

目的评价急性肺损伤肺保护性通气加乌司他丁干预改善肺呼吸功能,降低病死率的作用。方法76例急性肺损伤(ALI)患者随机分为肺保护性通气组(对照组n=37)和肺保护性通气加乌司他丁干预组(实验组n=39),实验组予乌司他丁20万U加入生理盐水100 ml静滴,每天2次,6天为一疗程。观察两组间生命体征、HR、平均动脉压、血气等改变,统计住院期间ICU病死率。结果实验组乌司他丁治疗后,肺损伤得到控制者28例(71.79%),与对照组的17例(45.94%)比较有显著性差异(P<0.05)。实验组HR明显下降,PaO2上升,PaO2/FiO2显著上升,与对照组比较,有非常显著性差异(P<0.01)。住院中ICU病死率实验组为25.64%,与对照组的59.45%比较,也有非常显著性差异(P<0.01)。结论乌司他丁对急性肺损伤肺保护性通气具有改善肺功能作用,并可降低住院病死率。

Objective To evaluate the lung protective ventilation and Ultinastatin intravenous effects to interfere the lung respiratory efficiency and lower the fatality rate of acute lung injury（ALI）. Methods 76 patients of ALI were randomly divided into lung protective ventilation group（control group n= 37） and lung protective ventilation affected with Ulinastatin intravenous group （experimental group n= 39）. Experimental group applied 20thousand U Ulinastatin, twice everyday, six days a treatment, apart with the ventilation therapy. The changing of life objective sign, HR, average artery pressure, blood gaseous analysis in both groups were observed. And the fatality rate in ICU was count. Results 28 cases lung injury in experiment group were improved after applied Ulinastatin treatment（71. 79%）, there was significant difference （ P 〈0.05）with that in control group （45.94%）. HR decreased and PaO2 , PaO2/FiO2 significant increased in experiment group,there were significant difference compared with those of control group（ P〈0.01）. So do the fatality rate in ICU（ P〈0.01）. Conclusion Ulinastatin treatment could do great help to acute lung injury apart with lung protective ventilation, reduce the fatality rate at the same time.