免疫球蛋白治疗脓毒血症相关性血小板减少症的疗效  

Clinical Efficacy of Immunoglobulin in Treatment of Sepsis-Associated Thrombocytopenia

作　　者：黄天然[1] 苏木珍 吕波[1] 何海燕[1] 

机构地区：[1]肇庆市第一人民医院儿科,广东肇庆526000 [2]肇庆市第一人民医院内分泌内科,广东肇庆526000

出　　处：《锦州医科大学学报》2017年第2期19-22,共4页Journal of Jinzhou Medical University

摘　　要：目的观察免疫球蛋白治疗脓毒血症相关性血小板减少症的临床疗效。方法选取2015年7月至2016年7月我院接受治疗的65例脓毒血症相关性血小板减少症患者作为研究对象,按随机数字表法将患者分为对照组32例和观察组33例,对照组给予内科综合治疗,观察组在对照组基础上给予免疫球蛋白静脉滴注治疗,于治疗前与治疗后1、3、5 d,检测两组患者的血小板计数,急性生理和慢性健康状况评分Ⅱ(APACHEⅡ)评分的变化,并统计两组治疗期间的出血发生率、28 d病死率以及ICU入住时间。结果于治疗后第3天起,观察组的血小板计数明显高于对照组,APACHEⅢ评分明显低于对照组,差异均有统计学意义(P<0.05);观察组的出血发生率、28 d病死率与ICU入住时间均明显少于对照组,差异均有统计学意义(P<0.05)。结论采用免疫球蛋白治疗脓毒症相关性血小板减少症可显著提高血小板数目,减少出血风险及患者死亡,故应予推广。Objective To observe the clinical efficacy of immunoglobulin in the treatment of sepsis-associated thrombocytopenia.Methods A total of 65 patients with sepsis-associated thrombocytopenia treated in our hospital from July 2015 to July 2016 were selected and randomly divided into control group （n=32） and observation group （n=33）.The control group was given medical treatment,while the observation group was treated with intravenous infusion of immunoglobulin along with the treatment given to the control group.The changes of platelet count,acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ） score of the two groups were detected before the treatment and on the first day,the third day,and the fifth day of the treatment.The incidence of bleeding,28-day mortality,and ICU stay during the treatment of the two groups were also statistically analyzed.Results Since the third day of the treatment,the platelet count in the observation group had been significantly higher than that of the control group,and the APACHE Ⅱ score was remarkably lower than that of the other group,with statistically significant difference （P〈0.05）.The observation group had lower incidence of bleeding and 28-day mortality and shorter ICU stay during the treatment than the control group with statistically significant difference （P〈0.05）.Conclusion The use of immunoglobulin in the treatment of sepsis-associated thrombocytopenia can significantly increase the number of platelets,and reduce the risk of bleeding and death of patients,which makes it worth to be promoted.

关 键 词：脓毒症 血小板减少症 免疫球蛋白 临床疗效 

分 类 号：R588.2[医药卫生—内分泌]