| 王喜波 田阔 张建楠 李媛媛 赵鸣雁.常规剂量乌司他丁对脓毒性休克患者的疗效观察[J].,2016,16(22):4251-4255 |
| 常规剂量乌司他丁对脓毒性休克患者的疗效观察 |
| Clinical Observation of Conventional-dose Ulinastatin in Septic Shock |
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| DOI： |
| 中文关键词: 脓毒性休克 乌司他丁 血流动力学 死亡率 |
| 英文关键词: Septic shock Ulinastatin Hemodynamics Mortality |
| 基金项目:黑龙江省教育厅科技研究项目资助（12541315） |
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| 中文摘要: |
| 目的：评价常规剂量乌司他丁联合早期目标导向治疗对脓毒性休克患者的治疗效果。方法：将符合脓毒性休克诊断的47 例
患者随机分为两组，对照组24 人（早期目标导向治疗）及观察组23 人（早期目标导向治疗＋ 乌司他丁20 万单位/次，2 次/ 天，连
续应用7 天）。在治疗过程中观察患者的血流动力学指标，乳酸值变化及血管活性药物的应用情况，同时记录机械通气的时间、
ICU住院时间，观察28 天患者住院死亡率。结果：47例脓毒性休克患者在治疗后的6、12、24、48、72小时动脉压上升、血乳酸值降
低，具有显著差异（P<0.05)；并且在治疗后的24，48，72 小时患者的心率减慢，更加趋于稳定（P<0.05)。实验组血管活性药物用量较
对照组减少，但无显著差异（P>0.05)。在治疗后的第3、5、7 天观察组较对照组SOFA 评分降低并具有统计学差异（P<0.05)，
APACHE-II评分两组间无显著差异（P>0.05)。实验组患者机械通气的时间明显短于对照组（P<0.05)，两者28 天住院死亡率未见
明显差别（P>0.05)。结论：常规剂量乌司他丁联合早期目标导向治疗可以改善脓毒性休克患者的血流动力学，缩短其在ICU 的住
院天数，降低机械通气时间。 |
| 英文摘要: |
| Objective:To investigate the clinical effect of conventional dose Ulinastatin and early goal-directed therapy (EGDT)
on patients with septic shock.Methods:47 patients diagnosed with septic shock were randomly divided into 2 groups, the control group
and the test group. The 24 patients in control group were given EGDT, and the 23 patients in experiment group were given conventional
dose Ulinastatin combined with EGDT. Hemodynamic status, lactic acid, and vasoactive drug use were observed during treatments; at the
same time, ventilator weaning time, ICU stay time, and 28-day hospital mortality were also recorded.Results:In both groups, mean
arterial pressure post-treatment levels were increased and lactic acid was decreased at 6, 12, 24, 48, and 72 h (P<0.05); and the heart rate
was decreased at 24, 48, and 72 h (P<0.05).The dosage of vasoactive drugs was reduced in treatment group, but difference between two
groups was not significant（P>0.05). Compared with control group, SOFA score in treatment group was reduced and difference between
two groups was significant in the third, fifth and seventh day after treatment（P<0.05). However, APACHE-II score was not significantly
different between two groups（P>0.05). Ventilator weaning time and ICU stay were significantly shorter in treatment group as compared
with controls, but 28-day hospital mortality did not appear statical differences（P>0.05).Conclusion:Conventional dose Ulinastatin and
early goal-directed therapy (EGDT) can improve hemodynamics, shorten ventilation and ICU stay time in treatment of patients with
septic shock. |
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