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乌司他丁治疗未液化脓性肝脓肿合并感染性休克的临床疗效:一项随机对照试验。

Clinical efficacy of ulinastatin in the treatment of unliquefied pyogenic liver abscess complicated by septic shock: A randomized controlled trial.

机构信息

Department of ICU, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, P. R. China.

Department of Hepatobiliary Surgery, The Affiliated Huaian No. 1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, P. R. China.

出版信息

Immun Inflamm Dis. 2023 Apr;11(4):e822. doi: 10.1002/iid3.822.

Abstract

INTRODUCTION

This study determined the therapeutic effect of ulinastatin (UTI) on unliquefied pyogenic liver abscesses complicated by septic shock (UPLA-SS).

METHODS

This was a randomized controlled trial involving patients with UPLA-SS who underwent treatment at our hospital between March 2018 and March 2022. The patients were randomly divided into control (n = 51) and study groups (n = 48). Both groups received routine treatment, but the study group received UTI (200,000 units q8h for >3 days). Differences in liver function, inflammatory indices, and effectiveness between the two groups were recorded.

RESULTS

Following treatment, the white blood cell count, and lactate, C-reactive protein, procalcitonin, tumor necrosis factor-α, and interleukin-6 levels were significantly decreased in all patients compared to the admission values (p < .05). The study group had a faster decline with respect to the above indices compared to the control group (p < .05). The study group length of intensive care unit stay, fever duration, and vasoactive drug maintenance time were all significantly shorter than the control group (p < .05). The total bilirubin, alanine aminotransferase, and aspartate aminotransferase levels were significantly lower in the study and control groups after treatment compared to before treatment (p < .05); however, the study group had a faster recovery of liver function than the control group (p < .05). The overall mortality rate was 14.14% (14/99); 10.41% of the study group patients died and 17.65% of the control group patients died, but there was no statistically significant difference between the two groups (p > .05).

CONCLUSION

UTI combined with conventional treatment significantly controlled the infection symptoms, improved organ function, and shortened the treatment time in patients with UPLA-SS.

摘要

简介

本研究旨在探讨尿胰蛋白酶抑制剂(UTI)治疗化脓性肝脓肿合并感染性休克(UPLA-SS)的疗效。

方法

这是一项随机对照试验,纳入了 2018 年 3 月至 2022 年 3 月在我院接受治疗的 UPLA-SS 患者。患者被随机分为对照组(n=51)和研究组(n=48)。两组均接受常规治疗,而研究组则接受 UTI(20 万单位,q8h,持续 >3 天)治疗。记录两组肝功能、炎症指标及疗效的差异。

结果

治疗后,与入院时相比,所有患者的白细胞计数及乳酸、C 反应蛋白、降钙素原、肿瘤坏死因子-α和白细胞介素-6 水平均显著下降(p<0.05)。与对照组相比,研究组上述指标的下降速度更快(p<0.05)。研究组患者的 ICU 住院时间、发热时间和血管活性药物维持时间均显著短于对照组(p<0.05)。与治疗前相比,治疗后研究组和对照组的总胆红素、丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平均显著降低(p<0.05);但研究组肝功能恢复速度快于对照组(p<0.05)。总死亡率为 14.14%(14/99);研究组死亡率为 10.41%,对照组死亡率为 17.65%,但两组间无统计学差异(p>0.05)。

结论

UTI 联合常规治疗可显著控制 UPLA-SS 患者的感染症状,改善器官功能,并缩短治疗时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9013/10108682/96be95603f0f/IID3-11-e822-g002.jpg

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