乌司他丁对肺癌术后急性呼吸窘迫综合征的治疗效果观察

Effect of ulinastatin in acute respiratory distress syndrome after lung cancer surgery

目的探究乌司他丁治疗肺癌术后急性呼吸窘迫综合征(ARDS)的疗效及对炎性因子、细胞免疫功能的影响。方法按照治疗方法的不同将100例肺癌术后ARDS患者分为观察组(n=54)和对照组(n=46)。比较两组患者治疗前后的生命体征、血气指标、炎性因子水平、肝肾功能和免疫功能。比较两组患者治疗后住重症监护室(ICU)时间、机械辅助通气时间、ICU病死率及急性生理学和慢性健康状况(APACHEⅡ)评分、多器官功能障碍综合征(MODS)评分。结果治疗后,观察组患者的心率(HR)、平均动脉压(MAP)、呼吸频率(RF)以及降钙素原(PCT)、白细胞介素-8(IL-8)、白细胞计数(WBC)、C反应蛋白(CRP)水平均低于对照组患者(P﹤0.05)。治疗后,观察组患者的CD4^+水平、CD4^+/CD8^+、动脉血氧分压与吸入氧浓度之比(PaO2/FiO2)和PaO2水平均高于对照组患者,天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、血清肌酐(Cr)和血尿素氮(BUN)水平均低于对照组患者(P﹤0.05)。观察组患者的住ICU时间、机械辅助通气时间均短于对照组患者,ICU病死率、APACHEⅡ评分和MODS评分均低于对照组患者(P﹤0.05)。结论乌司他丁治疗肺癌术后ARDS的疗效显著,能有效减少炎性反应,调节细胞免疫功能,且用药安全性高。

Objective To explore the curative effect of ulinastatin in acute respiratory distress syndrome(ARDS)after lung cancer surgery and its influence on inflammatory factors and cellular immune function.Method According to different treatment methods,100 ARDS patients after lung cancer surgery were divided into observation group(n=54)and control group(n=46).The vital signs,blood gas indexes,inflammatory factors,liver and kidney functions and immune functions of the two groups were compared before and after treatment.The intensive care unit(ICU)stay time,mechanical assisted ventilation time,ICU mortality,acute physiology and chronic health evaluation II(APACHE II)score and multiple organ dysfunction syndrome(MODS)score were compared between the two groups.Result The heart rate(HR),mean arterial pressure(MAP),respiratory frequency(RF),procalcitonin(PCT),interleukin-8(IL-8),white blood count(WBC)and C-reactive protein(CRP)in observation group after treatment were significantly lower than those in control group(P<0.05).The level of CD4^+,CD4^+/CD8^+,partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen(PaO2/FiO2)and PaO2 in observation group after treatment were significantly higher than those in the control group,aspartate aminotransferase(AST),alanine aminotransferase(ALT),serum creatinine(Cr),blood urea nitrogen(BUN)significantly lower than those in the control gorup(P<0.05).The ICU stay time and mechanical assisted ventilation time in the observation group were significantly shorter than those in the control group,and the ICU mortality rate,APACHE II and MODS score significantly lower than those in the control group(P<0.05).Conclusion Ulinastatin is effective in treating ARDS after lung cancer surgery,which can effectively reduce inflammatory reaction and regulate cellular immune function with high medication safety.