术中使用乌司他丁对新生儿坏死性小肠结肠炎患儿疗效的影响

Curative effect of intraoperative use of ulinastatin on neonatal necrotizing enterocolitis

目的观察术中使用乌司他丁对新生儿坏死性小肠结肠炎(necrotizing enterocolitis,NEC)患儿的疗效。方法将112例NEC手术患儿随机分为对照组56例和观察组56例。对照组患儿给常规治疗,观察组患儿在常规治疗的基础上给予乌司他丁2万U/kg术中静脉泵注治疗,观察两组临床治疗效果及治疗前后感染指标与血清炎性因子水平变化情况及动脉血气乳酸水平变化。结果治疗后,观察组治疗总有效率明显高于对照组(P<0.05),术后48 h,观察组感染指标明显低于对照组(P<0.05);两组患儿TNF⁃α、IL⁃8、CRP水平均明显低于术前(均P<0.05),血气分析乳酸水平术后明显低于术前,且观察组各指标水平均明显低于对照组(均P<0.05)。结论术中使用乌司他丁静脉泵注治疗新生儿NEC能够明显改善患儿微灌注,降低感染指标,有效降低患儿血清炎性因子水平,临床疗效显著。

Objective To observe the effect of ulinastatin on neonatal necrotizing enterocolitis.Methods 112 children with necrotizing enterocolitis were randomly divided into control group(Group A,n=56)and obser⁃vation group(Group B,n=56).Group A was treated with conventional therapy,and Group B was given ulina⁃statin 20,000 units/kg intraoperative intravenous pump therapy on the basis of routine treatment,to observe the clinical therapeutic effect of the two groups and the changes of infection indexes,serum inflammatory factors and the changes of arterial blood gas and blood lactate before and after treatment.Results After treatment,the total effective rate of the Group B was significantly higher than that of the Group A(P<0.05),and the infection index of Group B was significantly lower than that of the Group A within 48 hours after the operation(P<0.05);the serum levels of tumor necrosis factor⁃α(TNF⁃α),interleukin⁃8(IL⁃8),C⁃reactive protein(CRP)in the two groups were significantly lower than those before treatment(P<0.05),and the blood gas analysis of lactic acid level after operation was significantly lower than that before operation,and the levels of each index in the Group B were significantly lower than those in the group A(P<0.05).Conclusion Intraoperative use of ulinastatin intravenous pump in the treatment of neonatal necrotizing enterocolitis has a significant clinical effect,and it can significantly improve the micro⁃perfusion of neonates,reduce the infection index,effectively reduce the level of serum inflam⁃matory factors in children,and significantly improve the treatment effect.