乌司他丁联合连续性血液滤过治疗多器官功能障碍综合征53例临床观察

Clinical observation of 53 cases with multiple organ dysfunction syndrome treated with ulinastatin combines with continuous veno-venous hemofiltration

目的观察乌司他丁(UT)和连续性血液滤过(CVVH)治疗多器官功能障碍综合征(MODS)临床疗效。方法103例MODS患者随机分为两组:对照组50例采用常规及CVVH治疗;治疗组53例在对照组的基础上加用乌司他丁。观察两组患者治疗前后APACHE评分,观察肿瘤坏死因子-α(TNF-α)、血栓素B2(TXB2)、6-酮-前列腺素F1A(6-keto-PGF1a)、肾功能的变化以及ICU住院天数、CVVH应用时间和患者死亡风险率。结果两组患者治疗后APACHE评分均明显下降;血清TNF-α、TXB2均较治疗前显著下降(P<0.05),血清6-keto-PGF1a均显著上升(P<0.05),但治疗组上述指标均优于对照组(P<0.05)。两组患者死亡率无显著差异,但治疗组患者ICU住院天数及CVVH应用时间均优于对照组(P<0.01)。结论UT联合CVVH治疗MODS可取得更好疗效。

Objective To observe the clinical curative effect of treatment for multiple organ dysfunction syndrome with ulinastatin combines with eontinous veno-venous hemofiltration. Methods 103 cases of patients with multiple organ dysfunction syndrome were divided into two groups at random： 50 cases were control group treated with routine treatment and CVVH and 53 cases treated with intravenous injection of ulinastatin in addition to the same treatment as control group. The clinical situation of patients before and after treatment, hospital days in ICU, time for treatment with CVVH, dead risk for group, score of APACHE Ⅱ , serum concentration of TNF-α, TXB2 and F1A （6-keto-PGFla）, and change of renal function were observed. Results Score of APACHE Ⅱ , serum concentration of TNF-α and TXB2 were significantly decreased （P〈0.01） and F1A（6-keto-PGFla） significantly inereased（P〈0. 01） after treatment for both groups, however, these parameters in treatment group were more significant than that in control group （P〈 0. 05）. There was no significance for clinical situation and mortality rate between two groups. The clinical curative effect of hospital days in ICU, time for treatment with CVVH, and dead risk for group is better in treatment group than in control group （P 〈 0. 05）. Conclusion The clinical curative effect of treatment for MODS with UT combines with CVVH is satisfied.