乌司他丁联合BAL预防烧伤合并呼吸道损伤患者肺部感染的临床研究

Clinical efficacy of ulinastatin combined with bronchoalveolar lavage(BAL)on prevention of pulmonary infection in burn patients with respiratory tract injury

目的研究乌司他丁联合经纤维支气管肺泡灌洗(BAL)预防烧伤合并呼吸道损伤患者肺部感染的作用。方法选取2018年8月—2019年12月于我院救治的92例烧伤合并呼吸道损伤的患者为研究对象,采用随机数字表法按1:1的比例分为对照组46例和联合组46例;对照组给予常规治疗和BAL治疗,联合组在对照组的基础上给予乌司他丁;观察两组患者肺部感染情况,感染控制时间,治疗前后血气分析相关指标及炎性因子指标水平变化。结果(1)联合组感染发生率26.09%明显低于对照组58.70%(χ^(2)=10.015,P=0.002),感染后控制时间明显低于对照组(P<0.05);(2)治疗前两组血气分析对比差异无统计学意义,治疗后两组患者血气指标水平明显改善(联合组SaO_(2)及PaO_(2)水平明显高于对照组,P<0.05;PaCO_(2)明显高于(应该是低于吧!)对照组,P<0.05);(3)两组患者炎性因子相关指标差异无统计学意义,治疗后两组患者炎性因子水平均明显改善(联合组PCT、IL-6及TNF-α水平明显低于对照组,P<0.05)。结论乌司他丁联合BAL能够预防烧伤合并呼吸道损伤患者的肺部感染,并能够明显改善患者血气相关指标和炎性因子指标水平,临床效果确切。

Objective To study the effect of ulinastatin combined with bronchoalveolar lavage(BAL)on the prevention of lung infection in burn patients with respiratory tract injury.Methods A total of 92 burn patients with respiratory tract injury treated in a hospital from August 2018 to December 2019 were selected as the research objects,and they were divided into a control group(46 cases)and a combined group(46 cases)according to the ratio of 1:1 by the random number method.The control group was given the routine treatment and BAL treatment,and the combined group was given ulinastatin on the basis of the control group.The pulmonary infection,infection control time,inflammatory factors,and the related indexes of blood gas analysis were observed before and after the treatments.Results(1)In the combined group,the incidence of infection was 26.09%,which was significantly lower than that in the control group(58.70%,(χ^(2)=10.015,P=0.002)),and the control time after infection was significantly shorter than that in the control group(P<0.05).(2)There was no significant difference in blood gas analysis between the two groups before treatment.After treatment,the levels of indexes of blood gas analysis in both groups improved,and the improvements in the combined group was significantly better than those in the control group[Sa O_(2)and Pa O_(2)levels in the combined group were significantly higher than those in the control group(P<0.05);Pa CO_(2)level in the combined group was significantly lower than that in the control group(P<0.05)].(3)There were no significant differences in inflammatory factors between the two groups before treatment.The levels of inflammatory factors in both groups improved after treatment,and the improvements in the combined group was significantly better than those in the control group[the levels of PCT,IL-6 and TNF-αin the combined group were significantly lower than those in the control group(P<0.05)].Conclusion Ulinastatin combined with BAL can prevent lung infection in burn patients with respiratory tract injury,and this therapy has an obvious clinical effectthat significantly improve the related indexes of blood gas analysis and the levels of inflammatory factors.