乌司他丁治疗合并凝血功能障碍危重症患者61例疗效分析

Analysis of Curative Effect of Ulinastatin in Treatment of 61 Patients with Severe Coagulation Dysfunction

目的探讨乌司他丁治疗合并凝血功能障碍危重症患者的临床疗效。方法选取该院于2013年7月—2017年6月收治的61例合并凝血功能障碍的危重患者,将其按随机数字表法分为两组,对照组30例采取常规对症治疗,观察组31例基于此,给予乌司他丁治疗,20万U/次,静注,1~3次/d。持续1周。分别在入院时、治疗1周后,记录并对比两组血小板计数(PLT)、弥漫性血管内凝血(DIC)评分、凝血酶原时间(PT)及急性生理与慢性健康(APACHE)评分。结果治疗后,观察组PLT[(155.81±38.95)×10~9/L]较治疗前[(58.45±14.61)×109/L]与对照组[(65.43±6.35)×10~9/L],明显更高(t=2.18,P=0.014,t=2.349,P=0.017),PT[(10.12±2.53)s]短于治疗前[(18.94±4.73)s]与对照组[(18.50±4.62)s](t=2.07,P=0.018;t=2.374,P=0.023);观察组APACHE[(12.94±3.23)分]与DIC[(5.23±1.30)分]评分均显著低于治疗前[(21.68±5.42)分、(7.88±1.97)分]与对照组[(20.54±5.13)分、(7.01±1.75)分](t=3.02、3.25,P=0.003、0.022;t=2.350、2.495,P=0.017、0.014)。结论针对合并凝血功能障碍危重症患者,采用乌司他丁治疗,可显著改善此症状,降低病情严重度。

Objective This paper tries to investigate the clinical efficacy of ulinastatin in the treatment of patients with coagulation dysfunction. Methods 61 cases with dysfunction of blood coagulation in this hospital from July 2013 to June 2017 were selected and were randomly divided into two groups. In the control group, 30 cases were treated with routine symptomatic treatment. In the observation group, 31 cases were treated with ulinastatin, 200000 U/times, intravenously, and 1-3 times/d. Continue for 1 week. Recorded and compared platelet count（PLT）, disseminated intravascular coagulation（DIC） scores, prothrombin time（PT）, and acute physical and chronic health（APACHE） scores on admission and after treatment for 1 week. Results After treatment, PLT [（155.81±38.95） ×10~9/L] in the observation group was significantly higher than that before [（58.45±14.61）×10~9/L] and in the control group [（65.43±6.35） ×109/L].（t=2.18, P=0.014; t=2.349, P=0.017）, PT [（10.12±2.53）s] shorter than before treatment [（18.94 ±4.73）s] and control group [（18.50 ±4.62）s]（t=2.07, P=0.018; t=2.374, P=0.023）; APACHE scores in the observation group [（12.94 ± 3.23） points] and DIC scores [（5.23±1.30）points] were significantly lower than before treatment [（21.68 ± 5.42） points,（7.88±1.97） points and control group of [（20.54 ±5.13） points,（7.01 ±1.75） points]（t =3.02, 3.25, P =0.003, 0.022; t =2.350, 2.495, P =0.017,0.014）. Conclusion For critically ill patients with coagulopathy, treatment with ulinastatin can significantly improve the symptoms and reduce the severity of the disease.