脓毒症患者早期应用血必净注射液治疗的临床研究  

The therapeutic effects of early administration of Xuebijing injection （血必净注射液） on patients with severe sepsis

作　　者：张晓娟[1] 章志丹[1] 穆恩[1] 梁英健[1] 栾正刚[1] 郑振[1] 肇冬梅[1] 李旭[1] 马晓春[1] 

机构地区：[1]中国医科大学附属第一医院重症医学科,辽宁沈阳110001

出　　处：《中国中西医结合急救杂志》2010年第3期172-174,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：天津市科技创新专项基金项目（06F22DSH00403）;天津市现代中药大品种群系统开发基金资助项目（2006）

摘　　要：目的观察早期应用血必净注射液治疗脓毒症患者的疗效。方法筛选本院2007年6月1日至2008年3月31日收治的脓毒症成年患者32例，按随机数字表法分为试验组（16例）和对照组（16例）。两组均参照2004年美国重症医学会制定的脓毒症治疗指南进行常规治疗；试验组早期加用血必净注射液100ml静脉滴注，每日2次，5d为1个疗程。患者入重症监护病房（ICU）后每日观察凝血酶原时间（PT）、活化部分凝血活酶时间（APTT）、血小板计数（PLT）、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、机械通气时间、住ICU时间以及入ICU24h后多器官功能障碍综合征（MODS）发生率、ICU治愈率和28d生存率。结果试验组治疗后，PT、APTT均较治疗前及对照组明显改善（P〈0．05或P〈0．01），两组间PLT变化则无明显差异；试验组机械通气时间及住ICU时间均明显短于对照组[（83．28±68．87）h比（249．21±269．86）h，（3．58±1．16）d比（14．54±3．63）d，均P〈0．053；且MODS发生率明显低于对照组（31．25％比37．50％，P〈0．01）。试验组与对照组患者ICU治愈率（87．50％比68．75％）、28d生存率（81．25％比68．75％）比较差异均无统计学意义。结论早期应用血必净注射液治疗可改善脓毒症患者的凝血指标，降低患者MODS发生率及缩短机械通气时间、ICU住院时间；而对ICU治愈率和28d生存率的改善作用无统计学意义。Objective To study the therapeutic effects of early administration of Xuebijing injection （血必净注射液） on patients with severe sepsis. Methods Thirty-two patients with sepsis admitted in the First Affiliated Hospital of China Medical University from June 1, 2007 to March 31, 2008 were screened and randomly divided into two groups： experimental and control groups （each, n = 16）. According to the sepsis guidelines of Society of Critical Care Medicine 2004, both groups accepted the routine treatment;the patients in the experimental group were additionally given early intravenous drip of Xuebijing injection 100 ml, twice a day, 5 days constituting one therapeutic course, while those in control group were not. Prothrombin time （PT）, activated partial thromboplastin time （APTT）, platelet count （PLT）, acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） score, duration of mechanical ventilation, the incidence of multiple organ dysfunction syndrome （MODS） occurring after 24 hours in intensive care unit （ICU）, duration in ICU, cure rate and 28-day survival rate were investigated daily in ICU in the two groups. Results A significant improvement of PT and APTT was observed, compared with that in the control group and that in the experimental group before treatment （P〈0.05 or P〈0.01）, while the PLT between the two groups did not have any significant difference; the duration of mechanical ventilation and days of ICU stay in experimental group were shorter than those in control group [（83. 28±68. 87） hours vs. （249. 21±269.86） hours, （3.58± 1.16） days vs. （14.54±3.63） days, both P〈0. 05], and the incidence of MODS was also obviously lower than that in the control group （31.25% vs. 37.50%, P〈0.01）. There were no significant differences in cure rate （87.50% vs. 68.75%） and 28-day survival rate （81.25% vs. 68.75%） between the two groups. Conclusion Early administration of Xuebijing injection can improve coagulation indexes and redu

关 键 词：脓毒症 血必净注射液 抗凝 

分 类 号：R285.6[医药卫生—中药学] R365[医药卫生—中医学]