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目的:探讨乌司他丁辅助治疗重症手足口病对患儿的肺保护作用。方法:选取2010年1月至2012年3月在我院ICU住院治疗的重症手足口病患儿60例,随机分为对照组29例和治疗组31例。对照组给予机械通气为主的综合治疗,治疗组在对照组治疗基础上予乌司他丁静脉注射,10 000 U/kg加入0.9%氯化钠注射液20 mL微量泵注射,1 h内注入,每12 h 1次,连用7d。比较两组患儿治疗前后的氧合指数(OI)、呼吸指数(RI)及血清IL-6、IL-10、TNF-α、CK-MB水平,比较两组患儿治疗前后PCIS评分及机械通气时间和ICU住院时间。结果:治疗后两组患儿氧合指数及呼吸指数均好转,但治疗组呼吸指数及氧合指数优于对照组(P<0.05);治疗后两组患儿血清IL-6、IL-10及TNF-α水平均不同程度降低,而治疗组水平下降更明显(P<0.05);治疗后两组患儿PCIS评分均升高,而治疗组高于对照组(P<0.05);治疗组机械通气时间短于对照组(P<0.05);两组患儿住院时间比较差异无统计学意义(P>0.05)。结论:乌司他丁辅助治疗重症手足口病,可改善血气指标,保护心肺功能,提高治疗效果,值得临床推广应用。
Objective: To investigate the protective effect of ulinastatin on lung in children with severe hand-foot-mouth disease. Methods: Sixty children with severe HFMD admitted to our hospital from January 2010 to March 2012 were randomly divided into control group (n = 29) and treatment group (n = 31). The control group was given mechanical ventilation-based comprehensive treatment. The treatment group was injected with ulinastatin intravenously on the basis of the control group, and injected with 20 mL micro-pump of 0.9% sodium chloride injection at 10 000 U / kg. , Once every 12 h, once every 7 days. The oxygenation index (OI), respiratory index (RI), serum IL-6, IL-10, TNF-α and CK-MB levels were compared between the two groups before and after treatment. Ventilation time and hospital stay in ICU. Results: After treatment, the oxygenation index and respiratory index in both groups improved, but the respiratory index and oxygenation index in the treatment group were better than those in the control group (P <0.05). After treatment, the levels of IL-6 and IL-10 (P <0.05). After treatment, the PCIS score of both groups increased, while the treatment group was higher than the control group (P <0.05). The treatment group The duration of mechanical ventilation was shorter than that of the control group (P <0.05). There was no significant difference in hospitalization time between the two groups (P> 0.05). Conclusion: Ulinastatin adjuvant treatment of severe hand-foot-mouth disease can improve blood gas index, protect heart and lung function and improve the therapeutic effect, which is worthy of clinical application.