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Ulinastatin with Low Molecular Weight Heparin in the Treatment of Acute Respir Atory Distress Syndrome

Author: YingManZhen
Tutor: FangQiang
School: Zhejiang University
Course: Internal Medicine
Keywords: Ulinastatin low molecular weight heparin acute respiratory distress syndrome effect
CLC: R563.8
Type: Master's thesis
Year: 2010
Downloads: 81
Quote: 0
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Abstract


Objective To study the effects of ulinastatin with early low molecular weight heparin in the treatment of acute respiratory distress syndrome (ARDS).Methods Selected 35 patients with acute respiratory distress syndrome patients, are in line with Europe and the United States in 1994 proposed a joint meeting of the diagnostic criteria of acute respiratory distress syndrome. Cases will be selected randomly divided into treatment group and control group, control group 16 cases,10 cases were males and 6 females with a mean age of 35.1 years of age; treatment group 19 cases,12 cases were males and 7 females with a mean age of 34.7 years. After the two groups of patients with ICU stay, ventilator-assisted ventilation were treated with anti-inflammatory+hormone+nutrition therapy, the treatment group was added on this basis, Ulinastatin 200,000 U+normal saline 40 mL intravenous injection of micro-pump,3 times/d, continuous 5 d; low molecular weight heparin 4100 U, subcutaneously 2 times/d, continuously for 1 week. Two groups of patients before treatment and after treatment, the first 3,5,7 days venous and arterial blood, serum determination of TNF-a, IL-1(3, APTT, D-dimer, platelet, arterial blood gas targets, recording duration of mechanical ventilation and death the number of cases, and comparative analysis.Results Before treatment control group and treatment group TNF-a, IL-1β, the difference was not statistically significant; with the extension of treatment time, two cases of TNF-a, IL-1βlevels were decreased, but the treatment group TNF-a, IL-1βlevels decreased more significantly (P<0.05). Pre-treatment control group and treatment group D-dimer, APTT, platelet comparison, no statistically significant difference; with the extension of treatment time, two cases of D-dimer levels were decreased, but the treatment group D-dimer Body content decreased more significantly (P<0.05), APTT, no significant difference between the changes in platelet. Pre-treatment control group and treatment group, PaO2, PaO2/FiO2 comparison, the difference was not statistically significant; with the extension of treatment time, two cases of PaO2, PaO2/FiO2 went up, but the treatment group increased more significantly (P<0.05).Conclusion Ulinastatin combined with the low molecular weight heparin can significantly reduce the acute respiratory distress syndrome in patients with inflammatory mediators, reducing inflammation, improving the patient’s blood clotting abnormalities, but did not increase the risk of bleeding at the same time be able to shorten the duration of mechanical ventilation, whether can significantly reduce mortality, pending further study.

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CLC: > Medicine, health > Internal Medicine > Respiratory system and chest diseases > Pulmonary disease > Respiratory failure
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