大剂量乌司他丁治疗感染性休克51例临床疗效观察

Observation of clinical effect by large dose of ulinastatin in the treatment of 51 septic shock cases

目的观察大剂量乌司他丁治疗感染性休克的临床疗效,并对其治疗效果进行评价,以期为感染性休克的临床治疗提供参考。方法 102例住院治疗的感染性休克患者,随机分为大剂量组和常规剂量组,每组51例。常规剂量组静脉推注乌司他丁20万U/次;大剂量组静脉推注乌司他丁100万U/次,记录两组患者治疗前后白细胞水平,并对两组患者的急性生理学与慢性健康状况评分、多器官功能障碍综合征(MODS)的发生率和住院时间进行比较评价。结果治疗前两组的急性生理学与慢性健康状况评分、白细胞水平比较差异无统计学意义(P>0.05);治疗后,常规剂量组的急性生理学与慢性健康状况评分为(25.21±2.46)分,大剂量组为(17.39±1.83)分;大剂量组患者的急性生理学与慢性健康状况评分明显低于常规剂量组(P<0.05)。常规剂量组治疗后的白细胞水平为(12.10±2.87)×109/L,大剂量组为(9.20±2.09)×109/L;治疗后两组患者白细胞水平都有所下降,且大剂量组的白细胞水平明显低于常规剂量组(P<0.05)。大剂量组住院时间为(21.73±6.51)d,常规剂量组为(26.61±7.32)d,常规剂量组患者住院时间明显长于大剂量组(P<0.05)。大剂量组患者MODS发生率为21.57%,常规剂量组为47.06%,常规剂量组患者MODS发生率明显高于大剂量组(P<0.05)。结论给予感染性休克患者大剂量乌司他丁治疗,可减轻患者病情,降低白细胞水平,减少MODS发生,缩短住院时间,其临床治疗效果良好,值得临床推广。

Objective To observe clinical effect by large dose of ulinastatin in the treatment of septic shock, and to evaluate its curative effect, in order to provide reference for clinical treatment of septic shock. Methods A total of 102 hospitalized patients with septic shock were randomly divided into large dose group and conventional dose group, with 51 cases in each group. The conventional dose group received ulinastatin by 200 thousand U/time through intravenous injection, and the large dose group received ulinastatin by 1 million U/time through intravenous injection. White blood cell levels were recorded before and after treatment in both groups. Comparison and evaluation were made on acute physiology and chronic health evaluation score, incidence of multiple organ dysfunction syndrome（MODS） and hospital stay time between the two groups. Results There was no statistically significant difference of acute physiology and chronic health evaluation score and white blood cell level between the two groups before treatment（P〉0.05）. After treatment, the conventional dose group had acute physiology and chronic health evaluation score as（25.21±2.46） points, which was（17.39±1.83） points in the large dose group. The large dose group had obviously lower acute physiology and chronic health evaluation score than the conventional dose group（P〈0.05）. The conventional dose group had white blood cell level after treatment as（12.10±2.87） ×109/L, which was（9.20±2.09）×109/L in the large dose group. Both groups had lower white blood cell level after treatment than those before treatment, while the large dose group had much lower white blood cell level than the conventional dose group（P〈0.05）. The large dose group had hospital stay time as（21.73±6.51） d, which was（26.61±7.32） d in the conventional dose group. The conventional dose group had obviously longer hospital stay time than the large dose group（P〈0.05）. The large dose group had incidence of MODS as 21.57%,which was 47.06% in the conventional dose group. The conventional dose group had higher incidence of MODS than the large dose group（P〈0.05）. Conclusion Implement of large dose of ulinastatin for treating septic shock patients can relieve disease state, decrease white blood cell level, reduce incidence of MODS and shorten hospital stay time. This method contains excellent clinical effect, and it is worth clinical promoting.