乌司他丁联合甲基强的松龙治疗急性重症放射性肺炎的应用与护理研究

Application of Ulinastatin combined with Methylprednisolone in the treatment of severe acute radiation pneumonia and research on nursing care

目的:探讨乌司他丁对急性重症放射性肺炎的治疗效果及护理对策。方法:将58例急性重症放射性肺炎患者分为两组,A组用乌司他丁联合甲基强的松龙治疗,B组用甲基强的松龙治疗;观察患者呼吸频率(RR)、肺部罗音、查肺CT、C反应蛋白(CRP)、氧合指数(OI)、血糖(BS)。做好患者生活护理、呼吸道护理、发热护理、用药护理等。结果:治疗前后A组RR、肺部罗音、肺CT、CRP、OI显著改善(P<0.001),B组也显著改善(P<0.05);A组较B组改善明显,差异有显著性(P<0.05);激素用量A组较B组减少,差异有显著性(P<0.05);BS变化A组较B组差异无显著性(P>0.05)。结论:乌司他丁对急性重症放射性肺炎有治疗作用,与甲基强的松龙合用疗效更好。精心的护理可以更有效控制放射性肺炎。

Objective： To evaluate the effectiveness of Ulinastatin combined with Methylprednisolone in the treatment of severe acute radiation pneumonia and nursing countermeasures. Methods 58 patients with severe acute radiation pneumonia were divided into two groups. In group A the patients were given a joint treatment with Ulinastatin and Methylprednisolone and in group B only Methylprednisolone therapy was adopted. The changes of respiratory rate （ RR ）, pulmonary rale, CT, C - reactive protein （CRP）, oxygenation index I OI） , blood sugar （BS） were observed and comprehensive nursing care such as life care, respiratory tract care, fever care, medication care were carried out. Results： RR, pulmonary rales, CT, CRP and OI were markedly improved before and after treatment in group A （ P 〈 0. 001 ） and those items mentioned were also improved in group B （ P 〈 0.05 ） ; The improvement of the items was superior in group A to that in group B and the difference was significant （ P 〈 0.05 ） ; hormone dosage was less in group A than that in group B （ P 〈 0.05 ） ; no significant difference was found in BS changes between the two groups （P 〉 0.05 ）. Conclusion： Ulinastatin has the therapeutic effect in the treatment of severe acute radiation pneumonia and the effect is much better when Ulinastatin is used combined with Methylprednisolone. Meanwhile careful nursing care can control radiation pneumonia more effectively.