血必净注射液联合乌司他丁注射液治疗大面积烧伤的疗效观察

目的 通过观察大面积烧伤患者血清前白蛋白(PA)的变化，评价联合应用血必净注射液与乌司他丁注射液的疗效。方法 120例重度以上烧伤患者完全随机分为血必净+乌司他丁组、血必净组、乌司他丁组和对照组各30例。各组均给予早期液体复苏、抗感染、营养支持、器官保护等治疗。血必净+乌司他丁组给予乌司他丁注射液20万U静脉滴注，2次/d，同时加用血必净注射液50 ml静脉滴注，2次/d，连续使用7d。血必净组给予血必净注射液50 ml静脉滴注，2次/d，连续使用7d。乌司他丁组给予乌司他丁注射液20万U静脉滴注，2次/d，连续使用7d。对照组给予等体积等渗盐水，连用7d。分别于To（入院后即刻）、T2（伤后48～72 h）、T4（伤后96～120 h）、T7（伤后168～192 h）抽取外周静脉血测定PA。结果 烧伤后患者PA水平均下降，在T4、T7 4组间两两比较差异均有统计学意义[T4：血必净+乌司他丁组(96.9±15.7) mg/L，血必净组(86.2±18.2)mg/L，乌司他丁组(75.6± 17.4) mg/L，对照组(64.9±18.2) mg/L;T7：血必净+乌司他丁组(70.3±25.0)mg/L，血必净组(58.2±27.1 )mg/L，乌司他丁组(47.3±14.7) mg/L，对照组(32.6±9.0) mg/L，P＜0.05或P＜0.01]。血必净+乌司他丁组较治疗前下降幅度小于血必净组、乌司他丁组和对照组（P＜0.05或0.01）。结论 血必净注射液联合乌司他丁注射液能明显改善重度烧伤患者的病情。

Clinical effect of Xuebijing combined with ulinastatin in treating extensive burns

Objective To evaluate the curative effect of Xuebijing combined with ulinastatin in the patients with extensive bum by observing the changes of prealbumin. Methods One hundred and twenty patients with burns were divided into Xuebijing combined with ulinastatin group, Xuebijing group, ulinastatin group and control group.All patients were given therapy including earlier fluid resuscitation, anti-infection, nutritional support and organ preservation, etc. The patients in Xuebijing combined with ulinastatin group received both Xuebijing injection for 7 days and ulinastatin for 7 days; the patients in group B received Xuebijing injection for 7 days; the patients in group C received ulinastatin for 7 days, and the patients in the control group were given equivalent saline solution. On the 4th and 7th day after injury,blood concentrations of PA were determined among the 120 patients. Results The level of PA decreased in each group after bum. There was a significant difference among all groups on the 4th and 7th day after injury[T4 : Xuebijing combined with ulinastatin group(96. 9 ± 15.7 ) mg/L, Xuebijing group( 86.2 ± 18.2) mg/L,ulinastatin group(75.6 ± 17.4) mg/L,control group(64.9 ± 18.2) mg/L;T7 : Xuebijing combined with ulinastatin group (70.3 ± 25.0 ) mg/L, Xuebijing group ( 58.2±27.1 ) mg/L, ulinastatin group ( 47.3 ± 14.7 ) mg/L, control group (32.6 ± 9.0)mg/L, P ＜ 0.05 or P ＜ 0.01]. Conclusion The treatment of Xuebijing combined with ulinastatin can significantly improve patients' condition and reduce the level of inflammatory factors.