乌司他丁丹参注射液联合治疗创伤后急性肺损伤的临床研究

目的 探讨乌司他丁、丹参注射液联合治疗对创伤后急性肺损伤(ALI)的效果及机制.方法 将60例急诊胸腹部创伤患者随机分为治疗组和对照组,每组30例,两组常规治疗相同.治疗组加用乌司他丁600 kU/d、丹参注射液30 mL/d静脉注射.观察两组患者治疗前后血气分析、住院时间、住ICU时间、急性呼吸窘迫综合征(ARDS)发生率和病死率,并测定血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平.结果 治疗组住院时间、住ICU时间、ARDS发生率和病死率均显著优于对照组(P<0.01);治疗组呼吸频率、动脉血氧分压、氧合指数改善程度均显著优于对照组(P<0.01);治疗组TNF-α、IL-6水平均显著低于对照组(P<0.01).结论 乌司他丁、丹参注射液联合治疗能显著改善创伤后急性肺损伤预后,缩短治疗时间,具有积极推广价值.

Clinical study of Ulinastatin and Salvia miltiorrhiza in the treatment of acute lung injury after the trauma

Objective To evaluate the curative effect and mechanisms of Ulinastatin and Salvia miltiorrhiza in the treatment of acute lung injury(ALI) after abdominal or thoracic trauma. Methods 60 emergency patients with abdominal or thoracic trauma were randomly divided into therapeutic group and control group with the same ordinary treatment. The patients in the therapeutic group were given Ulinastatin 600kU and Salvia miltiorrhiza 30 mL per day intravenously. The result of blood gas analysis, the days of hospitalization, the days of staying in ICU, incidence rate of ARDS and the mortality were observed. The TNF-α and IL-6 were determined. Results The days of hospitalization, the days of staying in ICU, incidence rate and mortality of ARDS were lower in the therapeutic group (P<0.01); the respiratory rate, PaO_2, PaO_2/FiO_2 were improved better in the therapeutic group (P<0.01); the level of TNF-α and IL-6 were lower in the therapeutic group (P<0.01). Conclusion Treatment of Ulinastatin and Salvia miltiorrhiza can significantly improve the outcome of ALI after the trauma, and shorten treatment time.