论文部分内容阅读
目的观察大剂量乌司他丁治疗感染性休克的临床疗效,并对其治疗效果进行评价,以期为感染性休克的临床治疗提供参考。方法 102例住院治疗的感染性休克患者,随机分为大剂量组和常规剂量组,每组51例。常规剂量组静脉推注乌司他丁20万U/次;大剂量组静脉推注乌司他丁100万U/次,记录两组患者治疗前后白细胞水平,并对两组患者的急性生理学与慢性健康状况评分、多器官功能障碍综合征(MODS)的发生率和住院时间进行比较评价。结果治疗前两组的急性生理学与慢性健康状况评分、白细胞水平比较差异无统计学意义(P>0.05);治疗后,常规剂量组的急性生理学与慢性健康状况评分为(25.21±2.46)分,大剂量组为(17.39±1.83)分;大剂量组患者的急性生理学与慢性健康状况评分明显低于常规剂量组(P<0.05)。常规剂量组治疗后的白细胞水平为(12.10±2.87)×109/L,大剂量组为(9.20±2.09)×109/L;治疗后两组患者白细胞水平都有所下降,且大剂量组的白细胞水平明显低于常规剂量组(P<0.05)。大剂量组住院时间为(21.73±6.51)d,常规剂量组为(26.61±7.32)d,常规剂量组患者住院时间明显长于大剂量组(P<0.05)。大剂量组患者MODS发生率为21.57%,常规剂量组为47.06%,常规剂量组患者MODS发生率明显高于大剂量组(P<0.05)。结论给予感染性休克患者大剂量乌司他丁治疗,可减轻患者病情,降低白细胞水平,减少MODS发生,缩短住院时间,其临床治疗效果良好,值得临床推广。
Objective To observe the clinical efficacy of high-dose ulinastatin in the treatment of septic shock, and to evaluate its therapeutic effect in order to provide a reference for the clinical treatment of septic shock. Methods 102 cases of hospitalized patients with septic shock were randomly divided into high-dose group and conventional dose group, 51 cases in each group. The conventional dose group was given 200,000 U / kg ulinastatin bolus. The high dose group was injected with 1 million U / kg ulinastatin. The levels of leukocytes in both groups were recorded before and after treatment. The acute physiology and Chronic health status score, multiple organ dysfunction syndrome (MODS) incidence and hospital stay for comparative evaluation. Results There was no significant difference in acute physiology, chronic health score and leukocyte level between the two groups before treatment (P> 0.05). After treatment, the score of acute physiology and chronic health status in routine dose group was (25.21 ± 2.46) (17.39 ± 1.83) in the high-dose group. The score of acute physiology and chronic health condition in the high-dose group was significantly lower than that of the conventional dose group (P <0.05). The levels of leukocytes in the conventional treatment group were (12.10 ± 2.87) × 109 / L and (9.20 ± 2.09) × 109 / L, respectively). After treatment, the level of leukocyte decreased in both groups, Leukocyte levels were significantly lower than the conventional dose group (P <0.05). The duration of hospitalization was (21.73 ± 6.51) days in high-dose group and (26.61 ± 7.32) days in conventional dose group, and was significantly longer in long-term dose group than in high-dose group (P <0.05). The incidence of MODS was 21.57% in high dose group and 47.06% in conventional dose group. The incidence of MODS in high dose group was significantly higher than that in high dose group (P <0.05). Conclusions High-dose ulinastatin in patients with septic shock can reduce the patient’s condition, reduce the level of white blood cells, reduce the incidence of MODS and shorten the hospital stay. The clinical effect is good and worthy of clinical promotion.