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目的评价大剂量盐酸氨溴索(AMB)联用乌司他丁(UTI)改善百草枯(PQ)中毒患者肺损伤的临床应用价值。方法对402例PQ中毒患者,198例实施常规治疗(对照组),204例实施大剂量AMB联合UTI治疗(联用组),分别通过检测患者的动脉血氧分压(PaO2)及肺部影像学改变,比较两组ARDS及MODS发生率,综合评估肺损伤的情况。结果联用组低氧血症、ALI/ARDS发生率均低于对照组(P<0.05);影像学表现明显减轻。入院时即出现MODS伴(或不伴)ARDS者病情发展迅速,预后不良。结论早期应用大剂量AMB联用UTI能减轻PQ对肺组织的损伤,促进肺泡或肺间质渗出液的吸收,减少肺纤维化的形成。
Objective To evaluate the clinical value of high-dose ambroxol hydrochloride (AMB) combined with ulinastatin (UTI) for improving lung injury in patients with paraquat (PQ) poisoning. Methods One hundred and forty-two patients with PQ poisoning were enrolled in the study. 198 patients received conventional therapy (control group) and 204 patients received high-dose AMB combined with UTI (combination therapy). Patients were divided into two groups: PaO2 and pulmonary images Learning changes, comparing the two groups ARDS and MODS incidence, a comprehensive assessment of lung injury. Results The incidence of hypoxemia and ALI / ARDS in combination group were significantly lower than those in control group (P <0.05). Imaging findings were significantly reduced. Admitted to hospital with MODS (or not) ARDS rapid progression of the disease, the prognosis is poor. Conclusion Early use of high-dose AMB combined with UTI can reduce PQ damage to lung tissue and promote the absorption of alveolar or interstitial exudate and reduce the formation of pulmonary fibrosis.