CAJ | 학술논문

目的探讨乌司他丁对急性呼吸窘迫综合征（ARDS）患者凝血功能的影响。方法将80例ARDS患者按随机数字表法分为治疗组和对照组，各40例。对照组给予机械通气、抗感染、营养支持治，治疗组在此基础上加用乌司他丁针10万U+0.9%氯化钠溶液100ml静脉滴注3次/d，连续7d。比较两组患者住ICU时间、机械通气时间、28d病死率以及治疗前后急性生理学与慢性健康状况Ⅱ（APACHEⅡ）评分、氧合指数、血浆凝血酶原时间（PT）、纤维蛋白原（FIB）和D-二聚体（D- D）水平及血小板计数（Plt）变化。结果治疗组住 ICU时间、28d病死率、APACHE Ⅱ评分均低于对照组（均P＜0.05），氧合指数、FIB、Plt水平均高于对照组（均P＜0.05），PT、D- D水平治疗后低于对照组（均P＜0.05）。结论在常规治疗的基础上，应用乌司他丁治疗能改善ARDS患者的凝血功能及炎症指标，缩短机械通气时间、入住ICU时间，降低病死率。
목적탐토오사타정대급성호흡군박종합정（ARDS）환자응혈공능적영향。방법장80례ARDS환자안수궤수자표법분위치료조화대조조，각40례。대조조급여궤계통기、항감염、영양지지치，치료조재차기출상가용오사타정침10만U+0.9%록화납용액100ml정맥적주3차/d，련속7d。비교량조환자주ICU시간、궤계통기시간、28d병사솔이급치료전후급성생이학여만성건강상황Ⅱ（APACHEⅡ）평분、양합지수、혈장응혈매원시간（PT）、섬유단백원（FIB）화D-이취체（D- D）수평급혈소판계수（Plt）변화。결과치료조주 ICU시간、28d병사솔、APACHE Ⅱ평분균저우대조조（균P＜0.05），양합지수、FIB、Plt수평균고우대조조（균P＜0.05），PT、D- D수평치료후저우대조조（균P＜0.05）。결론재상규치료적기출상，응용오사타정치료능개선ARDS환자적응혈공능급염증지표，축단궤계통기시간、입주ICU시간，강저병사솔。
Objective To investigate the effects of ulinastatin on blood coagulation in patients with acute respiratory dis-tress (ARDS). Methods Eighty ARDS patients were randomly divided into treatment group(n=40) and control group(n=40). Pa-tients in both groups received mechanical ventilation, anti- infection and nutritional support;patients in treatment group received ulinastatin injection 100,000U, q.8.h for 7d. The length of ICU stay, duration of mechanical ventilation, 28- d mortality, the A-PACHE II scores before and after treatment, oxygenation index (PaO2 / FiO2), plasma prothrombin time (PT), fibrinogen (Fib), D- dimer (D- D) concentration and platelet count(Plt) were compared between two groups. Results In the treatment group, the length of ICU stay, the 28- d mortality rate, APACHEⅡsccores were lower than those of control group (P<0.05);the oxygena-tion index, Fib and Plt were higher than those of the control group(P<0.05);the PT and D- D concentrations after treatment were lower than those in control group (P<0.05). Conclusion Administration of ulinastatin on the basis of routine treatment can im-prove the function of blood coagulation and the inflammatory index, shorten the duration of mechanical ventilation, ICU stay time and reduce mortality in patients with acute respiratory distress syndrome.