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(xué)》2013年碩士論文　論文類型：學(xué)位論文

【摘要】：目的探討大劑量烏司他丁對(duì)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(jī)分為常規(guī)劑量烏司他丁對(duì)照組25例和大劑量烏司他丁治療組25例。常規(guī)對(duì)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(shí),一天5次,翌日開始進(jìn)行常規(guī)治療,20萬U/次,2次/日。觀測(cè)兩組治療后第1d、3d、5d的APACHEII評(píng)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(fù)時(shí)間、病情穩(wěn)定所需時(shí)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(píng)分、ALT、 AST、Lac各指標(biāo)值均低于常規(guī)對(duì)照組。②大劑量治療組用藥后第1h、4h、12h、24h、72h的尿量的檢測(cè)值均高于常規(guī)對(duì)照組；大劑量治療組用藥后第1h、4h、12h、24h、72h的職檢測(cè)值均低于常規(guī)對(duì)照組；大劑量治療組用藥后第1h、4h、12h,24h、72h的SP檢測(cè)值均高于常規(guī)對(duì)照組。③大劑量治療組休克恢復(fù)時(shí)間明顯短于常規(guī)對(duì)照組；大劑量治療組住ICU天數(shù)明顯少于常規(guī)對(duì)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(jìn)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(jìn)感染性休克患者的病情的控制,改善預(yù)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(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R459.7

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