【摘要】 目的观察乌司他丁应用于食管癌放疗重症肺炎的治疗效果及对血清炎性因子的影响。方法选取在我院接受治疗的重症放射性肺炎患者83例,随机分为治疗组(42例)和对照组(41例)。两组患者均选用调强放疗技术,对照组患者给予亚胺培南3 g静滴+吸入用半胱氨酸雾化+甲强龙40 mg静脉注射,治疗组患者在对照组基础上加用乌司他丁20万单位静脉泵入。观察两组患者的撤机时间、ICU住院时间、抗生素降级时间及治疗效果,对比两组患者血清中的IL-6、IL-8、TNF-α和CRP水平。结果治疗组患者撤机时间、ICU住院时间、抗生素降级时间明显短于对照组(P<0.05)。治疗组患者的总有效率为90.48%,显著高于对照组的60.98%(P<0.05)。治疗前,两组患者的IL-6、IL-8、TNF-α和CRP水平比较,无明显差异(P>0.05);治疗后,两组患者的IL-6、LI-8、TNF-α和CRP水平均明显降低(P<0.05);且治疗组的上述指标明显优于对照组(P<0.05)。结论乌司他丁可以降低重症放射性肺炎患者血清中的炎性因子水平,可显著提高临床疗效,值得推广。更多还原

【Abstract】 Objective To observe the effect of ulinastatin in the treatment of severe radiation pneumonia related to esophageal cancer and its influence on serum inflammatory factors. Methods Eighty-three patients with severe rediation pneumonia were selected and randomly divided into treatment group(n=42) and control group(n=41). All the patients were treated with intensity modulated radiotherapy. The control group was given imipenem 3 g, ivgtt. +inhalation with cysteine atomization +armor dragon 40 mg iv; the treatment group was treated with ulinastatin 200 000 units through intravenous pump on the basis of the control group. The time of weaning, ICU hospitalization and antibiotic degradation time, treatment effects and the levels of scrum IL-6, IL-8, TNF-α and CRP of the two groups were compared. Results The time of weaning, ICU hospitalization and antibiotic degradation time of the treatment group were significantly shorter than those of the control group(P<0.05). The total effective rate of the treatment group was 90.48%, which was higher than 60.98% of the control group(P<0.05). Before treatment, there was no significant difference on the levels of scrum IL-6, IL-8, TNF-αand CRP between the two groups(P>0.05); after treatment, the levels of scrum IL-6, IL-8, TNF-α and CRP of the two groups were lower than those before treatment, and those of the observation group were lower than the control group(P<0.05).Conclusion Ulinastatin can reduce the serum inflammatory factors in patients with severe pneumonia related to esophageal cancer, it has significant clinical effect, which is worth to be promoted in clinc.更多还原