乌司他丁对胆道感染性休克患者血流动力学的影响

摘要

目的：探讨乌司他丁对胆道感染性休克患者的血流动力学影响。方法将50例胆道感染性休克患者按随机数字表法分为乌司他丁治疗组及对照组，每组25例。两组患者均给予常规治疗，治疗组在此基础上加用乌司他丁（30万U溶于0.9%氯化钠溶液100ml中）静脉滴注，输液速度是100ml/h，2次/d，连续使用7d，运用PiCCO技术监测两组治疗前、治疗后6、12、24、72h的平均动脉压（MAP）、心指数（CI）、血管外肺水指数（EVLWI）、心率（HR）的变化。结果治疗后，两组患者的MAP、CI均逐步上升，但是治疗组的上升情况较对照组显著（P＜0.05），EVLWI、HR均下降均逐步下降，且治疗组的下降速度较对照组快( P＜0.05)。结论乌司他丁可以改善胆道性感染性休克患者的血流动力学指标。%Objective To investigate the effect of ulinastatin on hemodynamics in patients with biliary infectious shock. Methods Fifty patients with biliary infectious shock were randomly assigned to receive routine medication (control group n=25) or ulinastatin in addition to routine medication (ulinastatin group, n=25). The change of MAP(mean arterial pressure), CI(cardiac in-dex), EVLWI (extra- vascular lung water index), HR (heat rate) were measured and compared between two groups. Results Af-ter treatment the MAP and CI were gradual y increased in both groups, but it was more marked in ulinstatin group than that in control group (P<0.05). The EVLWI, HR were gradual y decreased after treatment in both group, but the decrease rate in ulinas-tatin group was higher than that in control group (P<0.05). Conclusion The effect of ulinastatin on hemodianamics is more marked than that of routine medication in patients with biliary infectious shock.