To investigate the effect of continuous airway administration of low molecular weight heparin sodium combined with intravenous infusion of ulinastatin in the treatment of inhalation injury.

From January 2017 to December 2019, 24 patients with acute lung injury caused by massive burns combined with inhalation injury admitted to the Department of Burns, Heilongjiang Provincial Hospital were selected and their medical records were retrospectively analyzed. The patients were divided into treatment group and control group according to the random number table method, with 12 cases in each group. The control group was given routine treatment, including comprehensive treatments such as fluid replacement, anti-shock, wound management, nutritional support, anti-infection, and airway management. On the basis of treatment in the control group, the treatment group was given continual airway administration of low molecular weight heparin sodium solution (100 AxaIU/kg, 1 time/d) combined with intravenous infusion of ulinastatin (100, 000 U/time, 3 times/d) treatment for 2 weeks. Before treatment and after 2 weeks of treatment, acute physiology and chronic health evaluation (APACHE) Ⅱ score was used to evaluate the overall condition of the two groups of patients; the plasma levels of tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were detected by radio immunoassay; the blood gas indexes (oxygen partial pressure, carbon dioxide partial pressure, blood pH value and oxygenation index) of the patients were detected, and the mortality of the two groups of patients after 2 weeks of treatment was observed. Data were compared by t test and χ² test.

Before treatment, there was no significant difference in APACHE Ⅱ score between the control group and the treatment group (P>0.05); after 2 weeks of treatment, the APACHE Ⅱ score (12.1±3.3) points of the treatment group was significantly lower than that of the control group [(17.3±4.2) points], the difference between the two groups was statistically significant (t=6.31, P<0.05). Before treatment, there were no statistically significant differences in plasma TNF-α and CRP levels between the control group and the treatment group (with P values above 0.05); after 2 weeks of treatment, the plasma TNF-α and CRP levels of the treatment group were (4.3±0.4), (10.1±3.7) μg/L, significantly lower than those of the control group [(23.1±4.2), (26.6±4.4) μg/L], the differences between the two groups were statistically significant (t=4.32, 3.34; with P values below 0.05). Before treatment, there were no statistically significant differences in oxygen partial pressure, carbon dioxide partial pressure, blood pH value and oxygenation index between the control group and the treatment group (with P values above 0.05); after 2 weeks of treatment, the blood pH value of the patients in the control group and the treatment group were 7.43±0.06 and 7.38±0.23, respectively, there was no statistically significant difference between the two groups (t=0.18, P>0.05); the oxygen partial pressure and oxygenation index of the treatment group were (91.4±4.1) mmHg, 351.2±31.5, which were significantly higher than those of the control group [(73.6±3.8) mmHg, 286.3±21.1], the differences were statistically significant(t=3.25, 2.56; with P values below 0.05); the carbon dioxide partial pressure in the treatment group was (35.1±3.9) mmHg, which was significantly lower than that in the control group [(41.8±3.2) mmHg], the difference was statistically significant (t=2.13, P<0.05). After 2 weeks of treatment, the mortality rate of the treatment group was 8.33% (1/12), which was significantly lower than that of the control group [25.00% (3/12)], the difference was statistically significant (χ²=4.26, P<0.05).

Continual airway administration of low molecular weight heparin sodium combined with intravenous infusion of ulinastatin can significantly inhibit inflammation, improve lung function, and reduce the mortality rate.