乌司他丁对严重脓毒症患者凝血功能的影响  

Effects of ulinastatin on coagulation function in patients with severe sepsis

作　　者：张友华[1] 罗建宇[1] 吕光宇[1] 张磊[1] 蔡天斌[1] 

机构地区：[1]广西壮族自治区柳州市人民医院重症医学科,广西柳州545006

出　　处：《中国当代医药》2016年第1期149-151,共3页China Modern Medicine

基　　金：广西壮族自治区卫生厅计划课题(Z2014547)

摘　　要：目的探讨乌司他丁对严重脓毒症患者凝血功能的影响与治疗严重脓毒症的效果。方法收集我院ICU2013年5月~2015年1月收治的严重脓毒症患者92例,随机分为乌司他丁治疗组（46例）和对照组（46例）。两组患者均予液体复苏、抗感染等治疗,治疗组在对照组治疗的基础上加用乌司他丁20 0000 U,1次/8 h,共5 d,观察治疗前后两组血小板（PLT）、凝血酶原时间（PT）、活化的部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、凝血酶时间（TT）的变化。观察两组患者ICU停留时间及28 d生存率。结果对照组第2天和第5天PLT和FIB均明显下降,与治疗前比较,差异有统计学意义（P〈0.05）,PT、APTT、TT与治疗前比较,差异无统计学意义（P〉0.05）;治疗组第2天与治疗前凝血功能指标比较,差异无统计学意义（P〉0.05）,第5天PT、APTT、TT缩短,PLT和FIB均增高（P〈0.05）;第5天治疗组与对照组同期比较,治疗组PLT和FIB均有增高,PT、APTT、TT均缩短,差异有统计学意义（P〈0.05）;治疗组患者ICU停留时间少于对照组（P〈0.05）,治疗组患者28 d生存率高于对照组（P〈0.05）。结论乌司他丁可改善严重脓毒症患者凝血功能及预后。Objective To analyze the effects of ulinastatin on coagulation function in patients with severe sepsis,and to explore the clinical efficacy of ulinastatin in patients with severe sepsis. Methods From May 2012 to September 2014,a total of 92 patients with severe sepsis in the ICU were enrolled. They were divided into the treatment group（n=46） and the control group（n=46）.All the patients were given routine therapy by anti-infection and fluid resuscitation.The treatment group was treated ulinastatin 20 0000 U one time per eight hours on the basis of conventional therapy for 5 days.PLT,PT,APTT and FIB were observed before and after treatment in two groups.The time of ICU stay and the 28-day survival rate were observed in two groups. Results PLT and FIB declined significantly in the control group on the 2nd and 5thday（P〈0.05）.In the treatment group,When compared with the before treatment,PLT,PT,APTT,TT and FIB was same on the 2ndday（P〉0.05）, In the tneatment group, coagulation function had no statisically significant difference that than before treatment on the 2ndday（P〉0.05）,but PLT, PT,APTT and FIB were significantly improved on the 5 d（P〈0.05）.On the 5thday,PLT,PT,APTT and FIB were improved with the control group at the same time point（P〈0.05）.In the treatment group,the time of ICU stay was shorter than the control group,but the 28-day survival rate was higher（P〈0.05）.Conclusion Ulinastatin might improve coagulation function and increase survival rate of patients with severe sepsis.

关 键 词：脓毒症 乌司他丁 凝血功能 

分 类 号：R973.2[医药卫生—药品]