超大剂量乌司他丁在感染性休克中的应用

发布时间：2018-02-23 23:11

本文关键词： 乌司他丁感染性休克临床疗效观察　出处：《大连医科大学》2013年硕士论文　论文类型：学位论文

【摘要】：目的探讨大剂量乌司他丁对感染性休克患者的临床疗效。方法50例感染性休克患者被随机分为常规剂量乌司他丁对照组25例和大剂量乌司他丁治疗组25例。常规对照组给予乌司他丁20万U/次静脉推注,2次/日；大剂量治疗组给予乌司他丁100万U静脉推注,1次／半小时,一天5次,翌日开始进行常规治疗,20万U/次,2次/日。观测两组治疗后第1d、3d、5d的APACHEII评分、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转氨酶(AST)及血乳酸(Lac)的变化情况；两组患者用药后第1h、4h、12h、24h及72h的尿量、心率(HR)、收缩压(SP)；记录患者休克恢复时间、病情稳定所需时间及住ICU天数等。结果①两组治疗后第1d、3d、5d的大剂量治疗组APACHEII评分、ALT、 AST、Lac各指标值均低于常规对照组。②大剂量治疗组用药后第1h、4h、12h、24h、72h的尿量的检测值均高于常规对照组；大剂量治疗组用药后第1h、4h、12h、24h、72h的职检测值均低于常规对照组；大剂量治疗组用药后第1h、4h、12h,24h、72h的SP检测值均高于常规对照组。③大剂量治疗组休克恢复时间明显短于常规对照组；大剂量治疗组住ICU天数明显少于常规对照组。④病死率：常规组死亡17人,病死率68%,大剂量治疗组死亡9人,病死率36%。结论大剂量乌司他丁可以促进感染性休克患者尿量增加,收缩压明显升高,心率明显下降,。血液中ALT、AST及Lac的含量均得到控制。降低病死率,促进感染性休克患者的病情的控制,改善预后。
[Abstract]:Objective to investigate the clinical effect of high dose ulinastatin in patients with septic shock. Methods Fifty patients with septic shock were randomly divided into two groups: control group (n = 25) and control group (n = 25). In the high-dose treatment group, ulinastatin 1 million U intravenous injection was given once / half an hour, 5 times a day, and then the routine therapy was performed on the following day, 200,000 U / time twice a day. The APACHEII scores of the two groups were observed on the 1st day, 3d and 5d after treatment. The changes of alanine aminotransferase (alt), aspartate aminotransferase (AST) and lactate lactate Lacs (Lactic acid Lacs), the urine volume, heart rate, systolic blood pressure and recovery time of patients with shock were recorded at 1 h, 4 h, 12 h, 24 h and 72 h after treatment, and the changes of alt, aspartate aminotransferase, aspartate aminotransferase (AST) and lactate lactate lactobacillus (Lacc) were recorded. The time required for stable illness and the number of days of living in ICU. Results (1) the APACHEII scores and ASTL-Lac indexes in the high-dose treatment group were lower than those in the conventional control group on the 1st day, the 3rd day and the 5th day, and the urine volume was higher than that in the routine control group at 1 h, 12 h, 12 h, 24 h and 72 h after the treatment. In the high-dose treatment group, the occupational detection values were lower than those in the conventional control group at 1h, 4h, 12h and 24h respectively, and the SP detection values in the high-dose treatment group were significantly shorter than those in the conventional control group (P < 0.01), and the recovery time of shock in the high-dose group was significantly shorter than that in the conventional control group (P < 0.05). The days of living with ICU in the high dose treatment group were significantly less than that in the routine control group: 17 patients died in the routine group, and the fatality rate was 68 percent. In the high dose treatment group, 9 patients died and the case fatality rate was 36 percent. Conclusion Ulinastatin can increase urine volume, increase systolic blood pressure and decrease heart rate in patients with septic shock. The levels of alt AST and Lac in blood are controlled and the mortality is reduced. To promote the control of patients with septic shock and improve the prognosis.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R459.7

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