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目的探讨乌司他丁联合甲基强的松龙治疗急性吸入性有机氟中毒的临床疗效。方法抽取2011年7月至2015年12月在我院接受治疗的急性吸入性有机氟中毒患者51例,随机分组,对照组25例,观察组26例,对照组静脉滴注甲基强的松龙+生理盐水治疗,观察组静脉滴注乌司他丁+甲基强的松龙+生理盐水治疗,观察比较两组甲基强的松龙用量、疗程、肺部渗出吸收时间、病死率、不良反应发生情况及治疗前后患者中性粒细胞(PMN)、外周白细胞(WBC)、C反应蛋白(CRP)含量变化情况。结果观察组甲基强的松龙用量(1417.05±916.35)mg、疗程(6.35±1.64)d均小于对照组(5605.91±1641.58)mg、(11.33±6.32)d,差异具有统计学意义(P<0.05);治疗3d后、7d后,观察组PMN、WBC、CRP均低于对照组,差异具有统计学意义(P<0.05);观察组肺部渗出吸收时间低于对照组,差异具有统计学意义(P<0.05);对照组经治疗无效死亡2例,观察组无死亡病例;不良反应发生率组间比较,差异无统计学意义(P>0.05)。结论对急性吸入性有机氟中毒患者给予乌司他丁联合甲基强的松龙治疗,可有效改善患者中性粒细胞、外周白细胞及C反应蛋白水平,减少甲基强的松龙用量,缩短肺部渗出吸收及治疗时间,且安全性高,值得临床推广应用。
Objective To investigate the clinical efficacy of ulinastatin combined with methylprednisolone in the treatment of acute inhalational fluorosis. Methods Totally 51 patients with acute inhaled organic fluorosis who were treated in our hospital from July 2011 to December 2015 were randomly divided into control group (n = 25) and observation group (n = 26). The control group received intravenous methylprednisolone Long + saline treatment, the observation group intravenous ulinastatin + methylprednisolone + saline treatment, compared the two groups of methylprednisolone dosage, duration of treatment, pulmonary exudative absorption time, mortality , The incidence of adverse reactions and the changes of neutrophil (PMN), peripheral white blood cells (WBC) and C-reactive protein (CRP) in patients before and after treatment. Results The dosage of methylprednisolone in the observation group was 1417.05 ± 916.35 mg, and the duration of treatment was (6.35 ± 1.64) days, which was lower than that in the control group (5605.91 ± 1641.58) mg and (11.33 ± 6.32) days, respectively (P < 0.05). After 3 days of treatment, the PMN, WBC and CRP in the observation group were lower than those in the control group after 7 days, the difference was statistically significant (P <0.05); the absorption time of pulmonary exudation in the observation group was lower than that of the control group (P <0.05). There were 2 deaths in the control group and no deaths in the observation group. There was no significant difference between the two groups in the incidence of adverse reactions (P> 0.05). Conclusion The combination of ulinastatin and methylprednisolone for patients with acute inhalation fluorosis can effectively improve the level of neutrophil, peripheral leukocytes and C-reactive protein, reduce the dosage of methylprednisolone and shorten the dosage Pulmonary exudate absorption and treatment time, and high safety, it is worth to promote clinical application.