乌司他丁治疗重型颅脑损伤的临床疗效及预后分析

Clinical Efficacy and Prognostic Analysis of Ulinastatin in the Treatment of Severe Craniocerebral Injury

[目的]探讨乌司他丁对重型颅脑损伤的治疗效果和预后影响.[方法]重型颅脑损伤患者64例,随机分为两组,对照组给予常规治疗,观察组在常规治疗基础上给予乌司他丁20万U,每天3次,治疗10 d.分别于入院后d1、d3、d7、d14进行GCS评分,治疗d14时记录应激性溃疡、神经源性肺水肿、肝功能损害、肾功能损害发生率;于治疗后6个月评价治疗效果.[结果]观察组治疗后d7、d14GCS评分较对照组明显改善,差异有统计学意义（ P 〈0.05）;观察组病情稳定所需时间明显少于对照组,差异有统计学意义（ P 〈0.05）;治疗d14应激性溃疡、神经源性肺水肿、肝功能损害、肾功能损害的发生率比对照组明显减少,差异有统计学意义（ P 〈0.05）;6个月后的观察组神经功能恢复水平明显优于对照组,差异有统计学意义（ P 〈0.05）.[结论]乌司他丁能够有效地治疗重型颅脑损伤,促进患者神经功能恢复,并可降低其并发症和改善预后.

[Objective] To explore the efficacy of ulinastatin for the treatment of severe craniocerebral injury and its effect on the prognosis. [Methods] Sixty four patients with severe craniocerebral injury were randomly divided into observation group（ n = 32） and control group（ n = 32）. The control group was treated with conventional therapy. Based on the conventional therapy, the observation group was additionally treated with ulinastatin 200,000U 3 times a day for ten days. All patients＇ GCS scores were observed on the 1st, 3rd, 7th, 14th day after admission. The incidence rates of stress ulceration, neurogenic pulmonary edema and liver or kidney function injury were recorded on 14 days after treatment. The therapeutic effect was evaluated 6 months after treatment. [Results] Compared with the control group, the GCS score in the observation group were obviously improved, and the difference had statistical significance（ P 〈0. 05）. The time needed for stable condition of the observation group was significantly shorter than that of the control group（ P 〈0.05）. The incidence rates of stress ulceration, neurogenic pulmonary edema and liver or kidney function injury of the observation group were significantly lower than those of the control group at 14 days after treatment, and the difference had statistical significance（ P〈0.05）. The level of nervous function recovery at 6 months after therapy in the treatment group was better than that in the control group, and the difference had statistical significance（ P〈0.05）. [Conclusion]Ulinastatin for the treatment of severe craniocerebral injury is effective. It can improve the recovery of nervous function, and decrease the incidence of the complications, and improve the prognosis.