CAJ | 학술논문

目的：探讨乌司他丁治疗危重症血流感染患者全身炎性反应的临床效果，为临床治疗提供参考依据。方法选取2010年3月－2013年12月危重症患者血流感染所致全身炎性反应的74例，随机分为两组，对照组35例实施常规治疗，观察组39例在对照组基础上加用乌司他丁静脉滴注；记录其观察体温、呼吸频率、心率、白细胞计数、血肌酐、血乳酸、C‐反应蛋白、炎症因子水平及记录有创机械通气、IC U住院时间以及病死率等指标，数据采用SPSS13．0进行统计分析。结果对照组患者有创通气时间、ICU住院时间、病死率分别为（16．42±1．28） d、（27．72 ± 3．17）d和31．43％，观察组分别为（7．33±0．52）d、（15．23 ± 1．44）d和5．13％，观察组患者治疗时间和病死率均明显少于对照组，两组比较差异有统计学意义（P＜0．05）。结论对血流感染所致全身炎症反应的危重症患者实施乌司他丁治疗，可以显著改善患者生命体征、有效保护患者的肝肾功能、缩短治疗时间、改善预后，而且给药方便，可以作为一种常规的治疗手段进行临床推广。
목적：탐토오사타정치료위중증혈류감염환자전신염성반응적림상효과，위림상치료제공삼고의거。방법선취2010년3월－2013년12월위중증환자혈류감염소치전신염성반응적74례，수궤분위량조，대조조35례실시상규치료，관찰조39례재대조조기출상가용오사타정정맥적주；기록기관찰체온、호흡빈솔、심솔、백세포계수、혈기항、혈유산、C‐반응단백、염증인자수평급기록유창궤계통기、IC U주원시간이급병사솔등지표，수거채용SPSS13．0진행통계분석。결과대조조환자유창통기시간、ICU주원시간、병사솔분별위（16．42±1．28） d、（27．72 ± 3．17）d화31．43％，관찰조분별위（7．33±0．52）d、（15．23 ± 1．44）d화5．13％，관찰조환자치료시간화병사솔균명현소우대조조，량조비교차이유통계학의의（P＜0．05）。결론대혈류감염소치전신염증반응적위중증환자실시오사타정치료，가이현저개선환자생명체정、유효보호환자적간신공능、축단치료시간、개선예후，이차급약방편，가이작위일충상규적치료수단진행림상추엄。
OBJECTIVE To investigate the clinical effect of ulinastatin in the treatment of systemic inflammatory re‐sponse in patients with critical bloodstream infections so as to provide reference for clinical treatments .METHODS Totally 74 cases of critical patients with systemic inflammatory response caused by bloodstream infections were se‐lected from Mar .2010 to Dec .2013 and they were randomly divided into two groups .Conventional treatment was adopted in the control group with 35 patients and another 39 patients were given ulinastatin intravenously on the basis of the control group .Indicators like temperature ,respiratory rate ,heart rate ,leukocyte numbers ,serum creatinine ,blood lactic acid ,C‐reactive protein and inflammatory cytokines were observed and recorded .Other in‐dicators like invasive mechanical ventilation ,hospital stays in ICU and fatality rate were recorded too .SPSS 13 .0 software was adopted for statistical analysis .RESULTS The invasive ventilation time ,ICU length of stay and mor‐tality rate in control group were respectively (16 .42 ± 1 .28) d ,(27 .72 ± 3 .17) d and 31 .43% .In the observation group ,they were (7 .33 ± 0 .52) d ,(15 .23 ± 1 .44 ) d and 5 .13% .The curative time and mortality rate in the ob‐servation group were significantly less than the control group (P<0 .05) .CONCLUSION Ulinastatin treatment for critical patients with systemic inflammatory response caused by bloodstream infections can significantly improve the patient's vital signs ,effectively protect the patient's liver and kidney function ,shorten treatment time and im‐prove patients prognosis ,and ease administration ,hence it can be used as a routine means of treatment to pro‐mote in clinic .