上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (12): 1474-.doi: 10.3969/j.issn.1674-8115.2010.12.006

• 专题报道（创伤医学） • 上一篇    下一篇

乌司他丁对严重烧伤早期患者肺组织的保护作用

徐 鹏, 方 勇, 俞为荣, 倪 涛, 顾 钏, 李晓光   

  1. 上海交通大学 医学院附属第三人民医院烧伤整形科 创伤医学研究所, 上海 201900
  • 出版日期:2010-12-25 发布日期:2010-12-31
  • 通讯作者: 方 勇, 电子信箱: fang6242@hotmail.com。
  • 作者简介:徐 鹏（1975—）, 男, 主治医师, 硕士；电子信箱: xupeng197532@sina.com。

Protective effect of ulinastatin on lung tissues in early stage of serious burn

XU Peng, FANG Yong, YU Wei-rong, NI Tao, GU Chuan, LI Xiao-guang   

  1. Department of Burns &|Plastic Surgery, The Third People's Hospital, Institute of |Traumatic Medicine, Shanghai Jiaotong University School of Medicine, Shanghai 201900, China
  • Online:2010-12-25 Published:2010-12-31

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摘要：

目的 探讨常规体液复苏联合乌司他丁（UTi）治疗对严重烧伤早期患者急性肺组织损伤（ALI）的影响。方法 收集并回顾性分析烧伤面积≥50%总体表面积（TBSA）或Ⅲ度烧伤面积≥20%TBSA患者（不含合并吸入性损伤病例）的临床资料。69例患者中，接受常规体液复苏治疗36例（对照组），接受常规液体复苏联合乌司他丁治疗33例（UTi组）。根据患者治疗前及治疗后第1、3、5 天的动脉血氧分压(PaO2)与吸入氧浓度比值(PaO2/FiO2)、呼吸频率及胸部X线检查结果进行ALI评分，比较两组患者的ALI评分和ALI发生率。结果 两组患者治疗前和治疗后1 d的 ALI评分比较差异均无统计学意义（P>0.05）；UTi组治疗后第3 天和第5 天的ALI评分均显著低于对照组（P<0.05）。UTi组和对照组的ALI发生率分别为45.6%和 63.9%，两组间比较差异有统计学意义（P<0.05）。结论 常规体液复苏联合乌司他丁治疗能降低严重烧伤早期ALI的发生率，对患者的肺组织具有保护作用。

关键词: 烧伤, 乌司他丁, 肺损伤, 早期

Abstract:

Objective To investigate the effect of conventional fluid resuscitation combined with ulinastatin treatment on acute lung tissue injury (ALI) in early stage of serious burn. Methods The clinical data of patients with area of burn ≥50% total body surface area (TBSA) or area of burn of III degree ≥20% TBSA (patients with inhalation injury were excluded) were collected and retrospectively analysed. Among the 69 patients, 36 received conventional fluid resuscitation treatment (control group), and the other 33 were managed with conventional fluid resuscitation combined with ulinastatin (UTi group). ALI scoring was performed on the basis of ratio of arterial partial pressure of oxygen (PaO2) to fraction of inspired oxygen (PaO2/FiO2), respiratory frequency and chest X-ray findings before treatment and 1 d, 3 d and 5 d after treatment, and ALI scores and prevalences of ALI were compared between two groups. Results There was no significant difference in ALI scores before treatment and 1 d after treatment between two groups （P>0.05）, while ALI scores in UTi group were significantly lower than those in control group 3 d and 5 d after treatment （P<0.05）. The prevalence of ALI in UTi group was significantly lower than that in control group (45.6% vs 63.9%, P<0.05）. Conclusion Conventional fluid resuscitation combined with ulinastatin treatment decreases the prevalence of ALI in early stage of serious burn, which has protective effect on lung tissues.

Key words: burn, ulinastatin, lung injury, early stage