摘要
目的探讨连续性血液净化联合乌司他丁治疗热射病的临床疗效。方法选取我院ICU收治的40例重度中暑(热射病)患者,其中男性28例,女性12例,随机分为治疗组和对照组,对照组患者19例,男性13例,女性6例,平均年龄33.1岁,给予吸氧、心电监护、物理降温(冰帽、冰敷)、静滴4℃冷盐水降温及对症处理等常规治疗;治疗组患者21例,男性15例,女性6例,平均年龄32.9岁,治疗组是在对照组治疗的基础上加用连续性血液净化联合乌司他丁(每日2次,每次10万单位加入生理盐水100 ml静脉滴注,1.5 h滴完)治疗。结果从患者意识障碍改善情况及降温效果来看,治疗组治愈18例,遗留轻度神经功能障碍1例,死亡2例,治愈率为90.48%。对照组治愈12例,遗留轻度神经障碍3例,死亡4例,治愈率为78.95%;治疗组肛温下降总有效率95.24%,对照组肛温下降总有效率73.68%。从患者意识障碍改善情况、降温效果、MODS恢复情况、死亡人数及存活时间方面比较,治疗组患者治疗效果优于对照组,差异有统计学意义(P<0.05)。结论连续性血液净化联合乌司他丁治疗热射病疗效较好,是一种值得推广的救治措施。
Objective To explore the clinical efficacy of continuous blood purification treatment and ulinastatin in patients with heatstroke. Methods 40 cases of severe heatstroke patients treated the ICU of our hospital,including 28 males and 12 fe- males, were randomly treatment group and control group. In control group, 19 patients （ 13 males and 6 females,33.1 ± 5.4 years old） were given conventional treatment, such as oxygen inspiration, ECG monitoring, body temperature cooling by ice cap,ice bag and intravenous 4 ℃ saline. In treatment group, except for conventional treatment, 21 patients case （15 males and 6 females, 32.9±4.6 years） were treated with continuous blood purification treatment and ulinastatin （2 times per day, 100000 units into 100 ml saline,intravenously drip off 1.5 h） treatment. Results According to the function of the patient＇ s consciousness and the effect of the cooling, in treatment group, 18 cases were cured, 1 case survived with mild neurological dysfunction,2 cases were dead. The rate of cure was 90.48% in treatment group. In control group, 12 patients were cured, and 3 cases survived with mild neurological dysfunction,with four cases dead. The rate of cure was 78.95%. In treatment group,the effective rate of the cooling anal temperature was 95.24%, in control group, the effective rate of the cooling anal temperature was 73.68%. Compared with cases in control group, the effect of the treatment in the treatment group with continuous blood purification treatment and ulinasta-tin was better in consciousness improvement, anus temperature cooling, MODS recovery, the rate of mortality and time of survival （ P 〈 0.05 ）. Conclusion In patients with heatstroke, the effect of the treatment with continuous blood purification treatment and ulinastatin, a kind of treatment to be promoted, were better effect of conventional treatment.
出处
《中华全科医学》
2013年第11期1696-1697,1700,共3页
Chinese Journal of General Practice
