乌司他丁在重症肺炎伴急性呼吸窘迫综合征患者中的应用效果

Effect of Ulinastatin on Acute Respiratory Distress Syndrome Patients with Severe Pneumonia

目的探析乌司他丁在重症肺炎伴急性呼吸窘迫综合征(ARDS)患者中的应用效果。方法选取2021年4月至2022年4月河南省人民医院收治的72例重症肺炎伴ARDS患者作为研究对象,其中死亡脱落8例,共有64例纳入研究,依据随机数字表法分为两组,各32例。对照组接受基础治疗、俯卧位通气治疗,观察组在对照组基础上配合乌司他丁治疗。比较两组治疗前后肺功能指标、炎症因子、血气指标及并发症。结果观察组治疗总有效率(96.88%)高于对照组(87.50%)(P<0.05)。治疗前两组肺功能、炎症因子及血气指标比较差异无统计学意义(P>0.05);治疗后观察组呼吸道阻力、内源性呼气末正压(PEEPi)、肿瘤坏死因子-α(TNF-α)、血清白介素-6(IL-6)、降钙素原(PCT)较对照组低,静态顺应性(Cst)较对照组高(P<0.05),动脉血二氧化碳分压(PaCO_(2))、动脉血氧分压(PaO_(2))、氧饱和度(SaO_(2))均优于对照组(P<0.05)。观察组并发症发生率低于对照组(P<0.05)。结论乌司他丁可有效改善重症肺炎伴ARDS患者的肺功能水平,降低机体炎症因子水平,改善患者血气指标,减少并发症发生。

Objective To investigate the effect of ulinastatin in the treatment of severe pneumonia patients with acute respiratory distress syndrome(ARDS).Methods A total of 72 patients with severe pneumonia and ARDS admitted to Henan Provincial People’s Hospital from April 2021 to April 2022 were enrolled as research objects,among them,there were 8 cases of death and shedding.A total of 64 patients were included in the study,and were divided into two groups according to random number table method,with 32 cases in each group.The control group received basic treatment and prone ventilation treatment,and the observation group was treated with ulinastatin on the basis of the control group.The indexes of lung function,inflammatory factors,blood gas indexes and complications were compared between the two groups before and after treatment.Results The effective rate of observation group(96.88%)was higher than that(87.50%)of control group(P<0.05).There was no statistical difference in lung function,inflammatory factors and blood gas indexes between the two groups before treatment(P>0.05).After treatment,airway resistance,intrinsic positive end-expiratory pressure(PEEPi),tumor necrosis factor-α(TNF-α),serum interleukin-6(IL-6)and procalcitonin(PCT)in observation group were lower than those in control group,while static compliance(Cst)in observation group was higher than that in control group(P<0.05),and partial pressure of carbon dioxide in arterial blood(PaCO_(2)),arterial partial pressure of oxygen(PaO_(2))and oxygen saturation(SaO_(2))in observation group were better than those in control group(P<0.05).The complication rate of observation group was lower than that of control group(P<0.05).Conclusion Ulinastatin can effectively improve the lung function level of severe pneumonia patients with ARDS,reduce the level of inflammatory factors,improve the blood gas index of patients,and reduce the occurrence of complications.