乌司他丁联合连续性血液净化治疗重症脓毒症的效果及对微循环指标、炎症指标及预后的影响  

Effect of ulinastatin combined with continuous blood purification in the treatment of severe sepsis and its influence on microcirculation index,inflammation index and prognosis

作　　者：徐飞方 朱义洪 薛细松 XU Feifang;ZHU Yihong;XUE Xisong(Department of Emergency,The First Hospital of Putian,Putian 351100,China)

机构地区：[1]莆田市第一医院急诊科,福建莆田351100

出　　处：《黑龙江医药科学》2024年第1期145-147,共3页Heilongjiang Medicine and Pharmacy

摘　　要：目的:探讨重症脓毒症患者采用乌司他丁联合连续性血液净化(CBP)治疗的效果及对其微循环指标、炎症指标及预后产生的影响。方法:选取2021年12月至2023年5月莆田市第一医院ICU收治的重症脓毒症102例患者,根据其入院编号顺序按照1:1比例分至两组中,即对照组(n=51,予以单纯CBP治疗)与观察组(n=51,予以CBP+乌司他丁治疗),对两组治疗效果、微循环指标、炎症指标及预后情况进行综合对比分析。结果:观察组94.12%和对照组76.47%的总有效率比较,前者更具优势(P<0.05);两组治疗前后微循环指标差异显著,PVD、PPV及MFI提升显著,TVD下降显著,而观察组以上指标提升/下降幅度大于对照组,差异有统计学意义(P<0.05);两组治疗前后血清炎性因子水平差异明显,PCT、CRP及IL-10可见显著下降,但组间对比发现,观察组以上各指标更低(P<0.05);与对照组比较,观察组在机械通气、ICU住院及总住院时间方面更占优势,且28d病死率更低(P<0.05)。结论:乌司他丁联合CBP治疗重症脓毒症可提高治疗效果,不仅可有效改善机体微循环,还能减轻机体炎症反应,改善患者预后。Objective:To investigate the effect of ulinastatin combined with continuous blood purification(CBP)on microcirculation index,inflammation index and prognosis of patients with severe sepsis.Methods:The subjects of this study were selected from December 2021 to May 2023,a total of 102 cases,all of whom were patients with severe sepsis admitted to ICU of The First Hospital of Putian,were divided into two groups according to their admission sequence in a 1:1 ratio,namely the control group(n=51,which was treated with CBP alone)and the observation group(n=51,CBP+ulinastatin treatment),and the therapeutic effects,microcirculation indicators,inflammation indicators and prognosis of the two groups were comprehensively compared and analyzed.Results:Compared with the total effective rate of the observation group 94.12% and the control group 76.47%,the former has more advantages(P<0.05).There were significant differences in microcirculation indexes between the two groups before and after treatment,PVD,PPV and MFI increased significantly,while TVD decreased significantly,while the increase/decrease range of the above indexes in the observation group was greater than that in the control group,with statistical significance(P<0.05).The levels of serum inflammatory factors in the two groups were significantly different before and after treatment,and PCT,CRP and IL-10 decreased significantly,but the indexes in the observation group were lower than those in the control group(P<0.05).Compared with the control group,the observation group has more advantages in mechanical ventilation,ICU hospitalization and total hospitalization time,and the 28d mortality rate is lower(P<0.05).Conclusion:Ulinastatin combined with CBP in the treatment of severe sepsis can improve the therapeutic effect,not only can effectively improve the microcirculation of the body,but also can reduce the inflammatory response of the body and improve the prognosis of patients.

关 键 词：乌司他丁 重症脓毒症 微循环指标 炎症指标 预后 

分 类 号：R631.3[医药卫生—外科学]