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目的:观察乌司他丁对急性百草枯(PQ)中毒致肺损伤临床疗效。方法:将41例急性PQ中毒患者随机分为治疗组21例和对照组20例,所有患者均予洗胃、血液灌流+血液透析(HP+HD)及甲基强的松龙静脉注射等综合治疗,治疗组在对照组基础上加用乌司他丁20万单位+0.9%生理盐水100 m1静脉滴注,每日2次,连续3-5 d。比较两组动脉血气、X线胸片(第1、3、5天)变化、多脏器功能障碍综合征(MODS)(≥3个脏器)发生率、病死率、死亡病例的存活时间。结果:治疗后两组的动脉血气及X线胸片等较治疗前均有显著改善(P<0.01),且治疗组明显优于对照组(P<0.05);两组MODS发生率、病死率与死亡病例存活时间无明显差异(P>0.05)。结论:乌司他丁可改善PQ中毒后肺损伤患者动脉血气及X线胸片,对急性PQ中毒肺损伤有积极治疗作用。
Objective: To observe the clinical effect of ulinastatin on lung injury induced by acute paraquat (PQ) poisoning. Methods: A total of 41 patients with acute PQ poisoning were randomly divided into treatment group (n = 21) and control group (n = 20). All patients were given gastric lavage, hemoperfusion + hemodialysis (HP + HD) and intravenous injection of methylprednisolone Treatment, treatment group in the control group plus ulinastatin 200000 units + 0.9% saline 100ml intravenous infusion, 2 times a day, for 3-5 days. The changes of arterial blood gas, radiographs of chest X-ray (days 1, 3 and 5), incidence of multiple organ dysfunction syndrome (MODS) (≥3 organs), mortality and survival time were compared between the two groups. Results: Arterial blood gas and radiographs of the two groups were significantly improved after treatment (P <0.01), and the treatment group was significantly better than the control group (P <0.05). The incidence of MODS and mortality And death cases no significant difference in survival time (P> 0.05). Conclusion: Ulinastatin can improve arterial blood gas and chest X-ray in patients with lung injury after PQ poisoning and has an active therapeutic effect on acute PQ poisoned lung injury.