综合治疗联合乌司他丁在婴儿捂热综合征中的疗效分析

Efficacy of Comprehensive Treatment Combined with Ulinastatin in Infant Muggy Syndrome

目的探讨综合治疗联合乌司他丁在婴儿捂热综合征危重患儿中的临床治疗效果。方法选取40例婴儿捂热综合征危重患儿作为研究对象,随机将其分为对照组和治疗组,每组20例。对照组患儿采取降颅压、止惊、补液纠正酸中毒及呼吸机支持等常规治疗,治疗组患儿在常规治疗的基础上加用乌司他丁联合治疗,对比2组患儿入院24 h后血气分析各值的变化,并观察比较两者的机械通气时间和病死率。结果对比2组患儿治疗24 h后血气分析结果发现:对照组的△pH增值为(0.04±0.02),△BE增值(4.06±3.01)mmol.L-1,△Na+增值(2.58±2.26)mmol.L-1,△K+减值(-1.11±0.65)mmol.L-1,治疗组的△pH增值为(0.11±0.11),△BE增值(9.53±3.34)mmol.L-1,△Na+增值(6.84±2.44)mmol.L-1,△K+减值(-1.60±0.65)mmol.L-1,2组比较其差异有统计学意义(P<0.05)。对比2组患儿入院期间的机械通气时间,发现对照组机械通气时间为(10.60±2.06)d,治疗组为(5.05±1.67)d,2组比较差异有统计学意义(P<0.05)。对比2组患儿的病死率,对照组为50%,治疗组为15%,2组比较差异有统计学意义(P<0.05)。结论乌司他丁能较快地改善婴儿捂热综合征危重患儿的电解质及酸碱紊乱,缩短机械通气时间,降低病死率,具有重要的临床应用价值。

Objective To explore the clinical efficacy of comprehensive treatment combined ulinastatin in critically ill infants with muggy syndrome. Methods Forty critically ill infants with muggy syndrome were randomly divided into control group and treatment group, with 20 infants in each group. The control group was conventionally treated with reducing intracranial pressure, anticonvulsion, rehydration to correct acidosis and ventilator support. On the basis of conventional therapy, the treatment group was additionally given ulinastatin. Blood gas analysis values, duration of mechanical ventilation and mortality rate were compared between the two groups. Results At 24 hours after admission, pH value, BE value and Na~ concentrations respectively increased by （0.04±0.02）, （4.06± 3.01） mmol·L-1 and（2.58±2.26）mmol-L-1 in control group, and （0.11±0.11）, （9.53±3.34） mmol.L-1 and （6.84±2.44） mmol. L-1 in treatment group. In addition, K＋ concentrations decreased by （1.11±0.65） and （1.60±0.65） mmol .L-1 in control group and treatment group, respectively. The differences in blood gas analysis values were statistically significant between the two groups （P〈0.05）. Compared with control group, duration of mechanical ventilation obviously decreased in treatment group[ （10.60-＋2.06） days vs （5.05-＋ 1.67 ） days, P〈0.05 ], as well as mortality rate （50% vs 15%, P〈0.05 ）.Conclusion Ulinastatin canquickly improve the electrolyte and acid-base disorders, shorten the duration of mechanical ventilation and reduce the mortality in critically ill infants with muggy syndrome.