乌司他丁联合大剂量氨溴索治疗重度烧伤临床研究

Clinical Study on Ulinastatin Combined with High-Dose Ambroxol in the Treatment of Severe Burn

目的探讨乌司他丁联合大剂量氨溴索治疗重度烧伤的临床疗效。方法选取医院2015年6月至2018年1月收治的重度烧伤患者93例,按随机数字表法分为对照组(47例)和研究组(46例)。对照组患者予乌司他丁联合30 mg/kg氨溴索治疗,研究组患者予乌司他丁联合300 mg/kg氨溴索治疗,两组均治疗10 d。结果治疗后,两组患者氧化应激指标[丙二醛(MDA)、脂质过氧化物(LPO)、髓过氧化物酶(MPO)、总抗氧化能力(T-AOC)]水平均下降,且研究组低于对照组(P <0.05);两组患者肺功能指标[用力肺活量(FVC)、第1秒用力呼气容积(FEV_1)、最高呼气峰流速(PEF)]均较治疗前升高,且研究组高于对照组(P <0.05);两组患者动脉血氧分压(PaO_2)/吸入氧浓度百分比(FiO_2)和PaO_2均较治疗前升高,且研究组高于对照组(P <0.05);二氧化碳分压(PaCO_2)较治疗前降低,且研究组低于对照组(P <0.05);研究组并发症发生率为13.04%,显著低于对照组的51.06%(P <0.05)。结论乌司他丁联合大剂量氨溴索治疗重度烧伤,可明显改善肺功能及血气指标,抑制氧化应激反应,减少并发症发生,具有临床应用价值。

Objective To investigate the clinical effect of ulinastatin combined with high-dose ambroxol in the treatment of severe burn.Methods Totally 93 patients with severe burn admitted to our hospital from June 2015 to January 2018 were selected and divided into the control group(47 cases) and the study group(46 cases) according to the random number table method.The patients in the control group were treated with ulinastatin combined with 30 mg/kg ambroxol, while the patients in the study group were treated with ulinastatin combined with 300 mg/kg ambroxol.The two groups were treated for 10 days.Results After treatment,the levels of oxidative stress indicators [ malonaldehyde(MDA),lipid peroxide(LPO),myeloperoxidase(MPO) and total antioxidant capacity(T-AOC)] in the two groups were decreased,and those in the study group were lower than those in the control group(P < 0.05).The lung function indexes [ forced vital capacity(FVC), forced expiratory volume in one second(FEV1) and peak expiratory flow(PEF)] in the two groups were higher than those before treatment, and those of the study group were higher than those of the control group(P < 0.05).The partial pressure of oxygen(PaO2)/fraction of inspired oxygen(FiO2) and PaO2 in the two groups were higher than those before treatment,and those in the study group were higher than those in the control group(P < 0.05).The partial pressure of carbon dioxide(PaCO2) in the two groups was lower than that before treatment,and that in the study group was lower than that in the control group(P < 0.05).The incidence rate of complications in the study group was 13.04 %, which was significantly lower than 51.06 % in the control group(P < 0.05).Conclusion Ulinastatin combined with high-dose ambroxol in the treatment of severe burn can significantly improve lung function and blood gas indexes,inhibit oxidative stress response and reduce complications,which has clinical application value.