乌司他丁联合无创机械通气对急性胰腺炎合并ARDS患者血气分析指标、炎性因子及预后生存的影响被引量：13

Effects of Ulinastatin Combined with Noninvasive Mechanical Ventilation on Blood Gas Analysis Indexes,Inflammatory Factors and Prognoses of Patients with Acute Pancreatitis Complicated by ARDS

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摘要目的探讨乌司他丁联合无创机械通气对急性胰腺炎合并急性呼吸窘迫综合征(ARDS)患者血气分析指标、炎性因子及预后生存的影响。方法选取2012年12月—2018年12月收治的93例急性胰腺炎合并ARDS,根据治疗方案不同分为对照组48例和观察组45例。对照组给予无创机械通气治疗,观察组给予乌司他丁联合无创机械通气治疗。治疗1周后,比较两组临床疗效,治疗前后动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、氧合指数、白细胞介素-4(IL-4)、IL-6、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)水平。分析两组的不良反应发生及预后生存情况。结果观察组治疗总有效率高于对照组(P<0.05)。治疗后,两组PaCO_(2)、IL-4、IL-6、TNF-α水平较治疗前下降,PaO_(2)、氧合指数、IFN-γ水平较治疗前升高,且观察组PaCO_(2)、IL-4、IL-6、TNF-α水平低于对照组,PaO_(2)、氧合指数、IFN-γ水平高于对照组(P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。观察组生存率高于对照组(P<0.05)。结论乌司他丁联合无创机械通气治疗急性胰腺炎合并ARDS的效果较为理想,该方案安全性高,能显著改善动脉血气分析指标及炎性因子,患者预后较好。 Objective To investigate the effects of Ulinastatin combined with noninvasive mechanical ventilation(NIMV)on blood gas analysis indexes,inflammatory factors and prognoses of patients with acute pancreatitis complicated by acute respiratory distress syndrome(ARDS).Methods A total of 93 patients with acute pancreatitis complicated by ARDS admitted between December 2012 and December 2018 were selected and divided into control group(n=48)and observation group(n=45)according to different therapeutic schemes.Control group was treated with NIMV,while observation group was treated with Ulinastatin combined with NIMV.After treatment for one week,clinical efficacy,levels of arterial oxygen partial pressure(PaO_(2)),arterial carbon dioxide partial pressure(PaCO_(2)),oxygenation index,interleukin-4(IL-4),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)andγInterferon(IFN-γ)before and after treatment were compared between two groups.Conditions of adverse reactions,prognoses and survival were analyzed in two groups.Results The total effective rate in observation group was significantly higher than that in control group(P<0.05).After treatment,levels of PaCO_(2),IL-4,IL-6 and TNF-αwere significantly lower,while levels of PaO_(2),oxygenation index and IFN-γwere significantly higher than those before treatment in two groups;in observation group,levels of PaCO_(2),IL-4,IL-6 and TNF-αwere significantly lower,while levels of PaO_(2),oxygenation index and IFN-γwere significantly higher than those in control group(P<0.05).There was no significant difference in incidence rate of adverse reactions between two groups(P>0.05).The survival rate in observation group was significantly higher than that in control group(P<0.05).Conclusion Ulinastatin combined with NIMV may achieve satisfactory efficacy in treatment of patients with acute pancreatitis complicated by ARDS.This scheme has good safety,and it may significantly improve arterial blood gas analysis indexes and inflammatory factors with good patients'prognoses.

作者南青范超亮路伟王艳艳 NAN Qing;FAN Chao-liang;LU Wei;WANG Yan-yan(Department of Digestive Emergency,the First Affiliated Hospital of PLA Air Force Medical University Xijing Hospital,Xi'an 710032,China)

机构地区空军军医大学第一附属医院(西京医院)消化急诊科

出处《临床误诊误治》 CAS 2021年第12期49-53,共5页 Clinical Misdiagnosis & Mistherapy

基金陕西省重点研发计划项目(2018SF-135)。

关键词急性胰腺炎急性呼吸窘迫综合征乌司他丁无创机械通气血气分析白细胞介素-4 肿瘤坏死因子-α Γ干扰素 Acute pancreatitis Acute respiratory distress syndrome Ulinastatin Non-invasive positive pressure ventilation Blood gas analysis Interleukin-4 Tumor necrosis factor-α Interferon-γ