血必净联合去甲肾上腺素对感染性休克疗效的影响  

Study on the effect of Xuebijing combined with norepinephrine on septic shock

作　　者：韩刚[1] 刘娟娟[2] 刘慧慧 惠雪红[4] 蔺亚莉 HAN Gang;LIU Juanjuan;LIU Huihui;HUI Xuehong;LIN Yali(Heart Center of Cardio Cerebral Vascular Unit, The Affiliated Hospital of Yan an University, Yan’an 716000, Shanxi, China;Department of General Medicine of Cardio Cerebral Vascular Special Wards, The Affiliated Hospital of Yan'an University, Yan’an 716000, Shanxi, China;Department of Clinical Laboratory, The Affiliated Hospital of Yan an University, Yan an 716000, Shanxi, China;Reproductive Health Center, The Affiliated Hospital of Yan an University, Yan an 716000, Shanxi, China)

机构地区：[1]延安大学附属医院心脑血管专科病区心脏中心,陕西延安716000 [2]延安大学附属医院心脑血管专科病区综合内科,陕西延安716000 [3]延安大学附属医院检验科,陕西延安716000 [4]延安大学附属医院生殖保健中心,陕西延安716000

出　　处：《西部医学》2019年第1期74-79,共6页Medical Journal of West China

基　　金：陕西省科技研究发展计划项目(2013KJ-93)

摘　　要：目的观察血必净联合去甲肾上腺素(NE)对感染性休克(SS)治疗的临床效果,并探讨其对患者血流动力学和血清C反应蛋白(CRP)、降钙素原(PCT)水平的影响。方法选取我院2015年6月～2017年6月收治的114例SS患者,采取随机数字表法均分为两组,对照组予以去甲肾上腺素治疗,观察组在此基础上加用血必净治疗,记录比较两组的临床疗效,治疗前后血流动力学指标及血清CRP、PCT水平变化,以及不良反应发生情况。结果治疗14d后,观察组总有效率为93.0%,较对照组的78.9%明显上升(P<0.05)。随治疗时间的延长,两组肺动脉楔压(PAWP)、中心静脉压(CVP)、血氧饱和度(SpO2)及心脏指数(CI)值均逐渐增加(P<0.05);且观察组治疗7、14d后上述指标改善均明显优于对照组(P<0.05)。两组血清CRP、PCT水平均随治疗时间的延长而逐渐下降(P<0.01);且观察组治疗7、14d后上述指标水平均较对照组更低(P<0.01)。而观察组和对照组不良反应发生率相比,差异无统计学意义(10.5%vs 14.0%,P>0.05)。结论血必净联合NE治疗感染性休克更能短期内消除或缓解患者的症状体征,改善微循环,提高治疗效果,且安全可靠。Objective To explore the clinical efficacy of Xuebijing combined with norepinephrine (NE) in patients with septic shock (SS) and its effects on hemodynamics, serum C reactive protein (CRP) and procalcitonin (PCT) levels. Methods 114 patients with SS treated in our hospital from June 2015 to June 2017 were selected and equally divided into two groups with the method of random number table. The control group was treated with norepinephrine. On the basis of control group treatment, the observation group was added with Xuebijing. The clinical efficacy, hemodynamic parameters, serum levels of CRP and PCT before and after the treatment and adverse reactions were recorded and compared between the two groups. Results After 14d of the treatment, the total effective rate of the observation group was 93.0%, which increased significantly compared with that of the control group (78.9%, P <0.05). With the prolongation of the treatment time, the value of pulmonary artery wedge pressure (PAWP), central venous pressure (CVP), blood oxygen saturation (SpO 2) and cardiac index (CI) of the two groups increased gradually ( P <0.05). After 7, 14 days of the treatment, the improvement of the above indicators in the observation group was significantly better than that of the control group in the same time period ( P <0.05). The serum levels of CRP and PCT both decreased gradually with the prolongation of the treatment time in the two groups ( P <0.01). After 7, 14 days of the treatment, the levels of the above indicators in the observation group was significantly lower than those of the control group in the same time period ( P <0.01). There was no significant difference in the incidence of adverse reactions between the observation group and the control group (10.5% vs 14.0%, P >0.05). Conclusion Xuebijing combined with norepinephrine in the treatment of septic shock can eliminate or alleviate the symptoms and signs of patients, improve microcirculation and the therapeutic effect safely and reliably.

关 键 词：感染性休克 血必净 去甲肾上腺素 血流动力学 C反应蛋白 降钙素原 

分 类 号：R441.9[医药卫生—诊断学]