Department of Emergency, The 904 Hospital of Joint Logistic Support Force, Wuxi, China.
Department of Nursing, The 904 Hospital of Joint Logistic Support Force, Wuxi, China.
Medicine (Baltimore). 2023 Feb 17;102(7):e32905. doi: 10.1097/MD.0000000000032905.
Severe multiple traumas are one of the most common diseases and carry a significant financial burden with high disability and mortality. There are no effective drugs in the clinical management of severe multiple traumas, and there is an absence of evidence-based medicine concerning the treatment of severe multiple traumas.
The present study explored whether ulinastatin (UTI) can improve the outcome of severe multiple traumas. The present research included patients who were hospitalized in intensive care units after being diagnosed with severe multiple trauma. Patients received UTIs (400,000 IU) or placebos utilizing computer-based random sequencing (in a 1:1 ratio). The primary outcome measures were 30-day mortality, multiple organ dysfunction syndrome, inflammatory response, coagulation function, infection, liver function, renal function, and drug-related adverse effects.
A total of 239 individuals were classified into 2 groups, namely, the placebo group (n = 120) and the UTI group (n = 119). There were no statistically significant differences in baseline clinical data between the 2 groups. The 30-day mortality and multiple organ dysfunction syndrome in the UTI group were remarkably improved compared with those in the placebo group. UTI can protect against hyperinflammation and improve coagulation dysfunction, infection, liver function, and renal function. UTI patients had markedly decreased hospitalization expenditures compared with the placebo group.
The findings from the present research indicated that UTIs can improve the clinical outcomes of patients with severe multiple traumas and have fewer adverse reactions.
严重多发伤是最常见的疾病之一,具有显著的经济负担,残疾率和死亡率高。在严重多发伤的临床管理中没有有效的药物,也缺乏关于严重多发伤治疗的循证医学证据。
本研究探讨了乌司他丁(UTI)是否能改善严重多发伤患者的预后。本研究纳入了在重症监护病房(ICU)诊断为严重多发伤后住院的患者。患者接受 UTI(400,000IU)或安慰剂(以 1:1 的比例),采用计算机随机排序。主要结局指标为 30 天死亡率、多器官功能障碍综合征、炎症反应、凝血功能、感染、肝功能、肾功能和药物相关不良反应。
共有 239 人分为 2 组,即安慰剂组(n=120)和 UTI 组(n=119)。两组患者的基线临床资料无统计学差异。与安慰剂组相比,UTI 组 30 天死亡率和多器官功能障碍综合征显著改善。UTI 可预防过度炎症反应,改善凝血功能障碍、感染、肝功能和肾功能。UTI 组患者的住院费用明显低于安慰剂组。
本研究结果表明,UTI 可改善严重多发伤患者的临床预后,且不良反应更少。