乌司他丁治疗重症中暑的临床疗效观察

Clinical Observation of the Efficacy of Ulinastatin for the Treatment of Severe Heatstoroke

[目的]探讨乌司他丁治疗重症中暑的疗效及对最终转归的影响.[方法]将收治的56例重症中暑的成年患者分为乌司他丁辅助治疗组（28例）和对照组（28例）.对照组予以ICU常规中暑治疗,治疗组除ICU常规中暑治疗外,入院后给予乌司他丁,200 kU,静脉注射,6 h 1次,连用6 d.观察治疗前后两组患者全身炎症反应综合征（SIRS）评分、血小板计数,凝血酶原时间、谷丙转氨酶、肌酐等指标变化及住ICU的时间、最终转归.[结果]治疗后两组患者SIRS评分、血小板计数,凝血酶原时间、谷丙转氨酶、肌酐等指标较治疗前均有改善,但治疗组改善更明显,且两组相比较有显著差异（P〈0.05）;两组患者住ICU的时间相比较有显著差异（P〈0.05）;治疗组死亡率较对照组降低,但无显著差异（P〉0.05）.[结论]乌司他丁可有效控制重症中暑患者SIRS的进展,改善各受损脏器的功能,减少多脏器功能障碍综合征（MODS）的发生,降低病死率.

[Objective]To explore the efficacy of ulinastatin for severe heatstoroke and its effect on the final turnover, [Methods] Fifty-six adult patients with severe heatstoroke were divided into ulinastatin treatment group（ n =28） and control group（ n =28）. The control group received the routine treatment of heat stroke. In additional to the routine treatment of heat stroke, the treatment group was given intravenous ulinastatin 200kU once per 6h for 6d. The changes of systemic inflammatory response syndrome（SIRS） score, platelet （PLT） count, prothrombin time（PT）, alanine aminotransferase（ALT） and creatinine（Cr）,the stay time in ICU and final turnover were observed in two groups before and after treatment. [Results] Compared before the treatment, SIRS score, PLT, PT, ALT and Cr after treatment were improved, and those in treatment group were improved more obviously, and there was significant difference between two groups（ P 〈 0.05）. There was also significant difference in the stay time in ICU between two groups（ P 〈0.05）. The mortality in the treatment group was lower than that in the control group, but there was no significant difference（ P 〉0.05）. [Conclusion]Ulinastatin can remarkably control the development of SIRS in the patients with severe heat stroke, improve the function of the damaged organs, and reduce the risk of multiple organ dysfunction syndrome（MODS） and the death rate.