乌司他丁联合地塞米松治疗急性呼吸窘迫综合征的疗效观察

Clinical observation of ulinastatin combined with dexamethasone in treatment of acute respiratory distress syndrome

目的观察注射用乌司他丁联合地塞米松磷酸钠注射液治疗急性呼吸窘迫综合征的临床效果。方法选取2016年3月—2017年3月成都市第二人民医院收治的急性呼吸窘迫综合征患者96例为研究的对象,将所有患者随机分为对照组和治疗组,每组各48例。对照组静脉滴注地塞米松磷酸钠注射液,5 mg加入到5%葡萄糖注射液250 m L中,2次/d。治疗组在对照组的基础上静脉滴注注射用乌司他丁,5万单位加入到5%葡萄糖注射液250 m L中,2次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较两组的住院时间、住重症监护室(ICU)时间、病死率和肺功能指标。结果治疗后,对照组和治疗组的总有效率分别为77.1%、95.8%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组住院时间、住ICU时间、病死率均低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组氧合指数均显著升高,治疗组呼吸频率显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论注射用乌司他丁联合地塞米松磷酸钠注射液治疗急性呼吸窘迫综合征具有较好的临床疗效,可以改善肺功能,缩短住院时间和住ICU时间,降低病死率,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Ulinastatin for injection combined with Dexamethasone Sodium Phosphate Injection in treatment of acute respiratory distress syndrome. Methods Patients（96 cases） with acute respiratory distress syndrome in Chengdu Second People＇s Hospital from March 2016 to March 2017 were randomly divided into control and treatment groups, and each group had 48 cases. Patients in the control group were iv administered with Dexamethasone Sodium Phosphate Injection, 5 mg added into 5% glucose solution 250 m L, twice daily. Patients in the treatment group were iv administered with Ulinastatin for injection on the basis of the control group, 50 000 units added into 5% glucose solution 250 m L, twice daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and hospitalization time, ICU stay time, fatality rate, and pulmonary function indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 77.1% and 95.8%, respectively, and there was difference between two groups（P〈0.05）. After treatment, hospitalization time, ICU stay time, and fatality rate in the treatment group were lower than those in the control group, and there was difference between two groups（P〈0.05）. After treatment, the oxygenation indexes in two groups were significantly increased, but the respiratory frequency in the treatment group were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Ulinastatin for injection combined with Dexamethasone Sodium Phosphate Injection has clinical curative effect in treatment of acute respiratory distress syndrome, can improve pulmonary function, shorten hospitalization time and ICU stay time, reduce fatality rate, which has a certain clinical application value.