垂体后叶注射液联合注射用乌司他丁治疗严重肺挫伤的临床观察

Clinical Observation of Posterior Pituitary Injection Combined with Ulinastatin for Injection in the Treatment of Severe Lung Contusion

目的:探讨垂体后叶注射液联合注射用乌司他丁治疗严重肺挫伤的疗效和安全性。方法:采用回顾性研究方法,选择我院2015年1月-2016年5月收治的严重肺挫伤患者60例,按照治疗方案分为对照组和观察组,各30例。对照组患者给予注射用乌司他丁10万U加至0.9%氯化钠注射液100mL中静脉滴注,bid;观察组患者在对照组基础上给予垂体后叶注射液6U加至0.9%氯化钠注射液49mL中静脉泵注(初始速率为0.008U/min,之后调整为≤0.04U/min),bid。两组患者均治疗1周。观察两组患者治疗前后的呼吸频率、肺挫伤简易评分、X线胸片评分、动脉血气指标[氧分压(PaO_2)、二氧化碳分压(PaCO_2)、血氧饱和度(SaO_2)和氧合指数(PO_2/FiO_2)]、炎症指标[白细胞介素2(IL-2)、IL-6、IL-10、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)]水平及临床疗效,并记录不良反应发生情况。结果:治疗前,两组患者呼吸频率、肺挫伤简易评分、X线胸片评分、动脉血气指标、炎症指标水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者呼吸频率、肺挫伤简易评分、X线胸片评分和IL-6、hs-CRP、TNF-α水平均降低,且观察组明显低于对照组,差异均有统计学意义(P<0.05);两组患者PaO_2、PaCO_2、SaO_2、PO_2/FiO_2、IL-2、IL-10水平均明显升高,且观察组明显高于对照组,差异均有统计学意义(P<0.05)。观察组临床总有效率(100%)明显高于对照组(86.67%),差异有统计学意义(P<0.05)。对照组患者的不良反应发生率(13.33%)明显高于观察组(6.67%),差异有统计学意义(P<0.05)。结论:垂体后叶注射液联合注射用乌司他丁对严重肺挫伤患者疗效较好,并能有效抑制机体炎症反应,且安全性较高。

OBJECTIVE:To investigate the therapeutic efficacy and safety of Posterior pituitary injection combined with Ulinastationfor injection in the treatment of severe lung contusion.METHODS:In retrospective study,60patients with severe lung contusionin our hospital from Jan.2015to May2016were divided into control group and observation group according to therapyplan,with30cases in each group.Control group was given Ulinastation for injection100thousand U+0.9%Sodium chloride injection100mL,ivgtt,bid.Observation group was additionally given Posterior pituitary injection6U+0.9%Sodium chloride injection49mL,intravenous pumping(initial rate was0.008U/min,adjusted to≤0.04U/min),bid,on the basis of control group.Both groups were treated for1week.The respiratory frequency,simple score of pulmonary contusion,chest X-ray score,the levels ofarterial blood gas indexes(PaO2,PaCO2,SaO2,PO2/FiO2)and inflammation indexes(IL-2,IL-6,IL-10,hs-CRP,TNF-α)beforeand after treatment as well as clinical efficacy were observed in2groups.The occurrence of ADR was recorded.RESULTS:Beforetreatment,there was no statistical significance in respiratory frequency,simple score of pulmonary contusion,chest X-ray score,the levels of arterial blood gas index or inflammation indexes between2groups(P>0.05).After treatment,respiratory frequency,simple score of pulmonary contusion,chest X-ray score,and the levels of IL-6,hs-CRP,TNF-αin2groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance(P<0.05).The levelsof PaO2,PaCO2,SaO2,PO2/FiO2,IL-2and IL-10in2groups were increased significantly,and the observation group was significantlyhigher than the control group,with statistical significance(P<0.05).Total response rate of observation group(100%)was significantly higher than that of control group(86.67%),with statistical significance(P<0.05).The incidence of ADR in controlgroup(13.33%)was significantly higher than observation group(6.67%),with statistical significance(P<0.05).CONCLUSIONS:Posterior pituitary injection combined with Ulinastatin for injection show good therapeutic efficacy for severe lung contusionand effectively inhibit inflammatory reaction with good safety.