早期大剂量乌司他丁与沐舒坦联合使用对特重度烧伤肺功能保护的临床研究

摘要

Objective:To study the large dose of ulinastatin combined with massage an easy application of severely burned patients with clinical effect of early lung function of protection.Methods:From January 2005 to June 2005 between the hospital make a diagnosis and give treatment of 286 cases of severe burn patients,randomly divided into treatment group (145 cases) and control group (141 cases). Treatment group:in traditional treatment such as liquid recovery,anti-infection and nutrition support,wound repair in a timely manner,on the basis of large dose combined with ulinastatin and soak up the comfortable.Control group:on the basis of conventional treatment,regular doses of combination of the above drugs.After treatment on two groups of patients with pulmonary oxygenation index and breathing through the calculation of blood gas analysis index,and according to the ALI grading evaluation of the lung function damage degree of two groups of patients.Results:Two groups of patients before treatment in respiratory frequency,PaO2/F iO2 value with Murray scoring no difference;Breathing rate treatment group after treatment was significantly lower than the control group, PaO2/F iO2 value higher than the control group,and lung injury score is lower than the control group.Before and after treatment of two groups of patients with ALI score no difference on the first day,all are mild lung injury;3,5d after treatment group after treatment remains steady at moderate lung injury,while control group showed severe lung damage.The results were statistically significant (P<0.05).Conclusion:Early application of high-dose ulinastatin combined with massage comfortable treatment of severe burn patients,and can reduce the damage of lung tissue and reduce the incidence of hypoxemia,protect the lung tissues and organs,and can provide certain reference basis for clinical treatment.%目的：研究大剂量乌司他丁联合沐舒坦应用对特重度烧伤患者早期肺功能的保护作用的临床效果。方法：选取2005年1月~2013年6月间入院诊治的特重度烧伤患者286例,随机分为治疗组(145例)与对照组(141例)。治疗组：在传统治疗如液体复苏、抗感染、营养支持、及时创面修复的基础上,大剂量联合使用乌司他丁与沐舒坦。对照组：在传统治疗的基础上,常规剂量联合使用上述药物。治疗后对两组患者通过血气分析计算肺氧合指数和呼吸指数,并根据ALI评分评价两组患者的肺功能损伤程度。结果：治疗前两组患者在呼吸频率、PaO2/F iO2值与Murray评分方面无差异；治疗后治疗组呼吸频率显著低于对照组,PaO2/F iO2值高于对照组,并且肺损伤评分低于对照组。治疗前与治疗后第一天两组患者的ALI评分无差异,均为轻度肺损伤；治疗后第3、5天后治疗组仍稳定在中度肺损伤,而对照组显示发生重度肺损伤。上述结果均具有统计学意义(P<0.05)。结论：早期应用大剂量乌司他丁联合沐舒坦治疗特重度烧伤患者,可以减轻对肺组织的损伤,降低低氧血症的发生率,起到保护肺部组织器官的作用,可为临床救治提供一定的参考依据。