大剂量盐酸氨溴索联用乌司他丁改善百草枯中毒患者肺损伤

目的 评价大剂量盐酸氨溴索(AMB)联用乌司他丁(UTI)改善百草枯(PQ)中毒患者肺损伤的临床应用价值.方法 对402例PQ中毒患者,198例实施常规治疗(对照组),204例实施大剂量AMB联合UTI治疗(联用组),分别通过检测患者的动脉血氧分压(PaO2)及肺部影像学改变,比较两组ARDS及MODS发生率,综合评估肺损伤的情况.结果 联用组低氧血症、ALI/ARDS发生率均低于对照组(P＜0.05)；影像学表现明显减轻.入院时即出现MODS伴(或不伴)ARDS者病情发展迅速,预后不良.结论 早期应用大剂量AMB联用UTI能减轻PQ对肺组织的损伤,促进肺泡或肺间质渗出液的吸收,减少肺纤维化的形成.

Clinical research of large dose of ambroxol plus ulinastatin in ameliorating pulmonary injury after paraquat poisoning

Objective To evaluate the value of high doses of Ambroxol hydrochloride(AMB) combined Ulinastatin(UTI) in ameliorating lung injury after paraquat(PQ) poisoning and its clinical application.Methods 402 cases of PQ poisoning,of which 198 cases of the implementation of conventional therapy(control group);204 cases of the implementation of high dose AMB Joint UTI treatment(plus group).Through the detection of patients with arterial oxygen partial pressure(PaO2),oxygen saturation(SaO2),and lung imaging,comparing 2 groups the incidence of ARDS and MODS,comprehensive assessment of the situation in lung injury.Results High dose group hypoxemia,ALI/ARDS incidence were lower than the control group(P<0.05);imaging significantly reduce performance.MODS on admission that was associated with(or without) ARDS patients from the rapid development of a poor prognosis.Conclusion Early application of high dose ambroxol GC ulinastatin PQ can reduce damage to lung tissue,and promote or pulmonary alveolar exudate absorption and reduce the formation of pulmonary fibrosis.