叶冬英++石斌++叶明荣++季镇星

[摘要]目的 探討乌司他丁联合大剂量氨溴索治疗重症肺炎的效果。方法 选取我院2013～2016年期间收治的确诊为重症肺炎患者的相关临床数据，从中随机抽取80例，以患者所接受干预方案差异为标准将其分为对照组、观察组，每组40例，采取常规重症肺炎对症治疗者为对照组，联合乌司他丁和大剂量氨溴索治疗者为观察组。比较两组患者的临床效果、治疗前后血气指标水平以及6 min步行距离情况。结果 观察组总有效率（95.0%）高于对照组（82.5%）；治疗后患者血氧分压和氧合指数水平均有所提高，且观察组水平[（61.2±10.3），（296.3±23.1）mmHg]高于对照组[（56.2±10.3），（159.1±25.7）mmHg]；治疗后两组患者6 min步行距离均延长，且观察组[（289.1±20.2）m]患者步行距离长于对照组[（256.9±19.8）m]，以上差异均有统计学意义（P<0.05）。结论 重症肺炎患者具有病情严重、预后质量较差等特点，为此类患者制定干预方案时除了考虑改善病情，还应该对各项指标以及康复质量等有所关注，乌司他丁联合大剂量氨溴索对该病不但能够控制病情，且血气指标水平和6 min步行距离也得到相对更为明显的提升，具有全面性优点，值得推广。

[关键词]乌司他丁；氨溴索；重症肺炎

[中图分类号] R563.1 [文献标识码] A [文章编号] 1674-4721（2017）04（a）-0128-03

Efficiency of ulinastatin combined high-dose ambroxol on patients with severe pneumonia

YE Dong-ying SHI Bin YE Ming-rong JI Zhen-xing

Department of Emergency Critical Care，the Central Hospital of Songjiang District in Shanghai，Shanghai 201600，China

[Abstract]Objective To explore efficiency of ulinastatin combined high-dose ambroxol on patients with severe pneumonia.Methods Clinical datas of patients in our hospital diagnosed with severe pneumonia from 2013-2016 were selected，from which a random sample of 80 cases were selected and divided into the control group and the observation group according to the intervention methods，with 40 cases in each group.Patients in the control group were received the general treatment for severe pneumonia，while patients in the observation group were received ulinastatin combined high-dose ambroxol on the basis of the control group.The chilical effect，the level of blood gas index and the walking distance of patients between two groups were compared.Results The effective rate of patients in the observation group（95.0%） was higher than that in the control group（82.5%）.After treatment，the levels of blood oxygen pressure and oxygenation index of patients in the observation group [（61.2±10.3），（296.3±23.1）mmHg] were higher than those in the control group[（56.2±10.3），（159.1±25.7）mmHg]； 6 minutes walking distance in of patients in the observation group [（2.89.1±20.21）m] were longer than that in the control group[（256.9±19.8）m].All the differences were statistically significant （P<0.05）.Conclusion The prognosis of severe pneumonia patients with severe pneumonia poor quality，intervention plans for such patients in addition to consider to improve the condition， also should be to focus on the indicators and the quality of rehabilitation， ulinastatin combined high-dose ammonia bromine， the disease can not only control the condition and blood gas index and 6 minutes walking distance is relatively more obvious increase， also has comprehensive advantages， is worth promoting.

[Key words]Ulinastatin；Ambroxol；Severe pneumonia

肺炎是临床发病率相对较高的疾病，如患者病情没有得到控制，不断恶化成为重症肺炎后严重威胁患者的健康。重症肺炎具有发病急、病情发展快等特点，患者除存在咳嗽、咳痰、呼吸困难等典型肺炎症状外，由于机体有多种炎性因子分泌，因此可合并呼吸衰竭、意识障碍、肾功能衰竭和休克等并发症，因该病死亡事件并不少见[1]。对重症肺炎患者尽快诊断并制定合理的干预措施，是保障预后质量的重要前提。以往重症肺炎患者的常规对症治疗虽然能在一定程度上控制患者病情状况，但对患者整体肺部和血气机能的改善却不明显，不利于提高患者生存舒适度，而治疗后的康复质量也较低，从长远而言并未取得令人满意的效果[2]。……