CAJ | 학술논문

目的分析乌司他丁对危重症患者凝血功能影响的临床疗效.方法收集2010年1月至2012年6月期间我院重症监护病房的危重症患者共60例,所有患者入选时的 APACHE Ⅱ评分>10分,排除原发性血液系统疾病、肿瘤、肝脏疾病及慢性器官功能不全患者.随机分为治疗组及对照组,对照组采用常规治疗,治疗组在常规治疗基础上加用乌司他丁20万 U,q8h,共7天.于入选当时及第2、8天早7:00抽取静脉血,行 PLT、PT、APTT、INR、Fib、D-D 二聚体.于第7天行 APACHE Ⅱ评分,记录 ICU 期间病死率.结果两组患者的年龄、性别组成及入组时 APACHE Ⅱ评分无显著性差异(P >0.05),具有可比性.治疗组第2 天和第 8天的 PLT、PT、APTT、INR、Fib 和 D-二聚体与第0天比较,明显改善(P <0.05),且与对照组同一时间点的组间比较,差异显著(P <0.05).比较两组患者APACHE Ⅱ评分及 ICU 病死率,治疗组治疗后 APACHE Ⅱ评分明显减低,且与对照组比较,差异显著(P <0.05);治疗组 ICU 病死率明显下降(P <0.05).结论乌司他丁对危重症患者凝血功能改善有较好疗效,且能改善病情及降低病死率.
목적분석오사타정대위중증환자응혈공능영향적림상료효.방법수집2010년1월지2012년6월기간아원중증감호병방적위중증환자공60례,소유환자입선시적 APACHE Ⅱ평분>10분,배제원발성혈액계통질병、종류、간장질병급만성기관공능불전환자.수궤분위치료조급대조조,대조조채용상규치료,치료조재상규치료기출상가용오사타정20만 U,q8h,공7천.우입선당시급제2、8천조7:00추취정맥혈,행 PLT、PT、APTT、INR、Fib、D-D 이취체.우제7천행 APACHE Ⅱ평분,기록 ICU 기간병사솔.결과량조환자적년령、성별조성급입조시 APACHE Ⅱ평분무현저성차이(P >0.05),구유가비성.치료조제2 천화제 8천적 PLT、PT、APTT、INR、Fib 화 D-이취체여제0천비교,명현개선(P <0.05),차여대조조동일시간점적조간비교,차이현저(P <0.05).비교량조환자APACHE Ⅱ평분급 ICU 병사솔,치료조치료후 APACHE Ⅱ평분명현감저,차여대조조비교,차이현저(P <0.05);치료조 ICU 병사솔명현하강(P <0.05).결론오사타정대위중증환자응혈공능개선유교호료효,차능개선병정급강저병사솔.
Objective To analyze the clinical efficacy of ulinastatin coagulation function in critically ill patients. Methods From January 2010 to June 2012, a total of 60 critically ill patients in the intensive care unit, who enrolled with APACHE Ⅱ score more than 10, excluding the primary blood system diseases, cancer, liver disease and chronic organ dysfunction patients. All patients were randomly divided into the treatment group or the control group. The patients in the control group were treated with conventional therapy, the treatment group was treated ulinastatin 200 000 u q8h on the basis of conventional therapy for 7 days. Venous blood was collected for PLT, PT, APTT and INR, Fib, the DD dimmer at 7:00 on the first,second and eighth day. APACHE Ⅱ scores on day 7,ICU mortality was recorded. Results Age, gender composition and into group APACHE Ⅱ score of the two groups was no significant difference (P>0.05) and was comparable. In the treatment group, compared with the first day, PLT, PT, APTT and INR, Fib and D-dimer in the 2d and 8d, was significantly improved (P<0.05) with the control group at the same time point. The difference was significant (P<0.05).. After the treatment, APACHE Ⅱ score and ICU mortality of patients in the treatment group, was significant declined (P<0.05); ICU mortality in the treatment group decreased significantly (P<0.05). Conclusion ulinastatin improved coagulation function in critically ill patients has a good effect, and can improve the condition and reduce mortality.