机械通气与乌司他丁治疗急性呼吸窘迫综合症的疗效观察

目的：观察机械通气与乌司他丁治疗急性呼吸窘迫综合症的临床疗效。方法：回顾性分析60例急性呼吸窘迫综合症患者的资料，治疗组（30例）采取机械通气与乌司他丁治疗，对照组（30例）采取机械通气治疗，观察两组的的呼吸频率、PaO2、PaO2／FiO2、PCO2、APACHEII评分、胸片变化、VAP发生率及病死率。结果：治疗组的呼吸频率、Pa02、PaO2/FiO2、PCO2指标均优于对照组（t=-6．39，6．27，24．07，9．82，P〈0．05）；治疗组的VAP发生率20．0％明显小于对照组的36．7％（x^2=5．84，P=0．016〈0．05）；治疗组的病死率3.3％明显小于对照组的16．7％（x^2=5．71，P=0．017〈0．05）。两组之间的APACHEII评分及胸片变化均有明显差异（t=7．14，6．33，P〈0．05）。结论：机械通气与乌司他丁治疗急性呼吸窘迫综合症的临床疗效较好，能够较好地改善肺功能，缓解ARDS患者症状，提高安全可靠性，控制死亡率。

Clinical Effect Observation of Mechanical Ventilation Combined with Ulinastatin in Treatment of Acute Respiratory Distress Syndrome

Objective： To observe the clinical effect of mechanical ventilation combined with ulinastatin in treatment of acute respiratory distress syndrome. Methods： Date of Sixty patients with acute respiratory distress syndrome were retrospectively analyzed, treatment group （30 cases） were treated using mechanical ventilation combined with ulinastatin; control group （30 cases） were treated using mechanical ventilation, then the respiratory frequency, PaO2, PaO2/FiO2, PCO2, APACHEII scores, chest radiograph change, VAP incidence and mortality in the two groups were observed. Results： Respiratory frequency, PaO2, PaO2/FiO2 and PCO2 in treatment group were better than those in control group （t=6.39, 6.27, 24.07, 9.82,P〈0.05）; VAP incidence was 20.0% in treatment group, and was less than 36.7% in control group （X2 =5.84, P=0.016〈0.05）; mortality （3.3%） in treatment group was less than 16.7% in control group （X^2=- 5.71, P=0.017〈0.05）. APACHEII scores and chest X-ray changes between the two groups had obvious difference （t=7.14, 6.33, P 〈 0.05）. Conclusion： The clinical effect of mechanical ventilation combined with ulinastatin in treatment of acute respiratory distress syndrome is good; the treatment can improve lung function, alleviates the symptoms, improves the safety and reliability and controls the mortality.