目的 研究山莨菪堿聯(lián)合烏司他丁治療急性呼吸窘迫綜合征的臨床效果。方法 選取2015年1月-2016年12月楊凌示范區(qū)醫(yī)院重癥監(jiān)護(hù)室收治的急性呼吸窘迫綜合征患者206例，按照住院順序分為對照組和治療組，每組各103例。對照組患者靜脈滴注烏司他丁注射液20萬單位加到5%葡萄糖500 mL，2次/d。治療組在對照組治療基礎(chǔ)上靜脈滴注鹽酸消旋山莨菪堿注射液，首次靜脈注射0.2 mg/kg，必要時每隔30分鐘重復(fù)給藥。兩組均連續(xù)治療14 d。觀察兩組治療前后臨床結(jié)局、一般臨床指標(biāo)、動脈血氧分壓（pO₂）、動脈二氧化碳分壓（pCO₂）、（pO₂/FiO₂）、白細(xì)胞計數(shù)（WBC）、C反應(yīng)蛋白（CRP）、降鈣素原（PCT）、白細(xì)胞介素-6（IL-6）的變化情況。結(jié)果 治療期間，對照組和治療組的死亡率分別為37.9%、20.4%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療組患者機(jī)械通氣時間、ICU住院時間均少于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組患者呼吸頻率、心率、APACHEⅡ評分、MODS評分、pCO₂、WBC、CRP、PCT、IL-6顯著降低，pO₂、pO₂/FiO₂顯著升高，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療后治療組呼吸頻率、心率、APACHEⅡ評分、MODS評分、pCO₂、WBC、CRP、PCT、IL-6低于對照組，pO₂、pO₂/FiO₂高于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 山莨菪堿聯(lián)合烏司他丁治療急性呼吸窘迫綜合征具有較好的臨床療效，可有效改善肺氧合功能，降低炎癥因子水平，減少機(jī)械通氣時間和住院時間，降低患者死亡率，具有一定的臨床推廣應(yīng)用價值。

Objective To research the clinical effects of anisodamine combined with ulinastatin in treatment of acute respiratory distress syndrome. Methods Patients (206 cases) with acute respiratory distress syndrome in Yangling Demonstration Zone Hospital from January 2015 to December 2016 were divided into control (103 cases) and treatment (103 cases) groups according to different hospital orders. Patients in the control group were iv administered with Ulinastatin Injection, 2×10⁵ U added into 5% glucose 500 mL, twice daily. Patients in the treatment group were iv administered with Raceanisodamine Hydrochloride Injection on the basis of the control group, and first intravenous injection was 0.2mg/kg, repeated every 30 min if necessary. Patients in two groups were treated for 14 d. After treatment, the clinical outcomes, general clinical indicators, pO₂, pCO₂, pO₂/FiO₂, WBC, CRP, PCT, and IL-6 in two groups before and after treatment were observed. Results After treatment, the mortality rate of control and treatment group was 37.9% and 20.4%, respectively, and there were differences between two groups (P<0.05). After treatment, mechanical ventilation time and ICU hospital time in the treatment group were shorter than those in the control group, and there were differences between two groups (P<0.05). After treatment, respiratory rate, heart rate, APACHEⅡ score, MODS score, pCO₂, WBC, CRP, PCT, and IL-6 in two groups were significantly decreased, but pO₂, pO₂/FiO₂ were significantly increased, and there were differences between two groups (P<0.05). After treatment, respiratory rate, heart rate, APACHEⅡ score, MODS score, pCO₂, WBC, CRP, PCT, and IL-6 were lower than those in the control group, but pO₂, pO₂/FiO₂ were higher than those in the control group, and there were differences between two groups (P<0.05). Conclusion Anisodamine combined with ulinastatin has clinical curative effect in treatment of acute respiratory distress syndrome, and can effectively improve lung oxygenation function, reduce inflammation factors, shorten mechanical ventilation time and hospitalization time, and reduce patient mortality, which has a certain clinical application value.