本文關(guān)鍵詞： 烏司他丁 感染性休克 臨床療效觀察　出處：《大連醫(yī)科大學》2013年碩士論文　論文類型：學位論文

【摘要】：目的探討大劑量烏司他丁對感染性休克患者的臨床療效。 方法50例感染性休克患者被隨機分為常規(guī)劑量烏司他丁對照組25例和大劑量烏司他丁治療組25例。常規(guī)對照組給予烏司他丁20萬U/次靜脈推注,2次/日；大劑量治療組給予烏司他丁100萬U靜脈推注,1次／半小時,一天5次,翌日開始進行常規(guī)治療,20萬U/次,2次/日。觀測兩組治療后第1d、3d、5d的APACHEII評分、丙氨酸氨基轉(zhuǎn)移酶(ALT)、天門冬氨酸氨基轉(zhuǎn)氨酶(AST)及血乳酸(Lac)的變化情況；兩組患者用藥后第1h、4h、12h、24h及72h的尿量、心率(HR)、收縮壓(SP)；記錄患者休克恢復時間、病情穩(wěn)定所需時間及住ICU天數(shù)等。 結(jié)果①兩組治療后第1d、3d、5d的大劑量治療組APACHEII評分、ALT、 AST、Lac各指標值均低于常規(guī)對照組。②大劑量治療組用藥后第1h、4h、12h、24h、72h的尿量的檢測值均高于常規(guī)對照組；大劑量治療組用藥后第1h、4h、12h、24h、72h的職檢測值均低于常規(guī)對照組；大劑量治療組用藥后第1h、4h、12h,24h、72h的SP檢測值均高于常規(guī)對照組。③大劑量治療組休克恢復時間明顯短于常規(guī)對照組；大劑量治療組住ICU天數(shù)明顯少于常規(guī)對照組。④病死率：常規(guī)組死亡17人,病死率68%,大劑量治療組死亡9人,病死率36%。 結(jié)論大劑量烏司他丁可以促進感染性休克患者尿量增加,收縮壓明顯升高,心率明顯下降,。血液中ALT、AST及Lac的含量均得到控制。降低病死率,促進感染性休克患者的病情的控制,改善預后。
[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.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R459.7

【參考文獻】

相關(guān)期刊論文 前10條

1 周琪;王剛;高長青;陳婷婷;;烏司他丁對體外循環(huán)冠脈搭橋手術(shù)圍術(shù)期炎癥反應的影響[J];中南大學學報(醫(yī)學版);2010年02期

2 徐鵬;方勇;俞為榮;顧釧;;烏司他丁對Ⅲ度燙傷大鼠肺組織的保護作用[J];上海交通大學學報(醫(yī)學版);2009年01期

3 苗鋒;陳剛;陳志明;龐烈文;馬勤運;陳佶;朱勇俊;;烏司他丁對大鼠肺臟熱缺血再灌注損傷的保護作用[J];復旦學報(醫(yī)學版);2010年04期

4 潘利偉,孫來芳,郭蕾;烏司他丁治療感染性休克的臨床療效觀察[J];實用醫(yī)學雜志;2005年11期

5 付笑飛;劉東雷;王建軍;;烏司他丁預先給藥對大鼠呼吸機相關(guān)肺損傷的影響[J];華中科技大學學報(醫(yī)學版);2010年05期

6 翟宇佳,王小雷;烏司他丁和抑肽酶對血液保護作用研究[J];中國體外循環(huán)雜志;2004年02期

7 萬獻堯;Sepsis診治進展[J];醫(yī)師進修雜志;2005年15期

8 吳向東;周峻峰;萬獻堯;;烏司他丁對復蘇后多器官功能障礙的防治作用[J];中國急救復蘇與災害醫(yī)學雜志;2007年03期

9 劉宇鵬;萬獻堯;;ICU臨終患者治療抉擇的倫理問題[J];醫(yī)學與哲學(臨床決策論壇版);2011年05期

10 焦以慶;王宇;劉景院;;ICU的核心內(nèi)容及臨床思維要點[J];醫(yī)學與哲學(臨床決策論壇版);2011年07期

，

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