血必净注射液对复杂腹腔感染脓毒症患者炎凝反应的影响  

The effect of Xuebijing injection on the inflammatory and coagulation response of complicated intraabdominal infection by sepsis

作　　者：崔文华 宋林超 程鹏 张仕娟 Cui Wenhua;Song Linchao;Cheng Peng;Zhang Shijuan(Department of Emergency Medicine,Yidu Central Hospital of Weifang,Weifang 262500,Shandong,China)

机构地区：[1]潍坊市益都中心医院重症医学科,山东潍坊262500

出　　处：《中国中西医结合急救杂志》2024年第2期141-144,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：山东省潍坊市科技发展计划项目(2023YX118)。

摘　　要：目的观察血必净注射液对复杂腹腔感染脓毒症患者炎凝反应的影响。方法采用回顾性研究方法。选择潍坊市益都中心医院2020年6月至2023年7月收治的274例复杂腹腔感染脓毒症患者作为研究对象。将患者按是否使用血必净注射液分为观察组(141例)和对照组(133例)。两组患者均给予常规治疗,观察组在常规治疗基础加用血必净注射液(100 mL 0.9%的氯化钠注射液加入血必净100 mL静脉滴注,每日2次,连续应用5 d)。比较两组治疗前和治疗后2、3、5 d炎症指标〔血清白细胞介素-6(IL-6)、降钙素原(PCT)、C-反应蛋白(CRP)和内毒素〕以及凝血功能指标〔D-二聚体、纤维蛋白原(FIB)、凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)〕水平的差异,并观察临床预后。结果两组治疗前各炎症指标和凝血功能指标比较差异均无统计学意义,随治疗时间延长,两组治疗后各炎症指标和凝血功能指标D-二聚体、FIB水平均较治疗前降低,PT、APTT均较治疗前缩短,治疗5 d达到最低水平,且观察组各炎症指标和凝血功能指标均明显低于对照组〔IL-6(ng/L):18.89±8.22比24.59±10.39,PCT(μg/L):0.30±0.16比0.52±0.20,CRP(mg/L):13.13±6.54比28.87±8.66,内毒素(kEU/L):0.17±0.06比0.22±0.08,D-二聚体(mg/L):1.75±0.61比1.96±0.77,FIB(g/L):2.50±0.78比3.10±0.94,PT(s):14.16±1.90比15.05±1.46,APTT(s):34.52±5.40比36.21±4.72,均P<0.05〕。观察组重症监护病房(ICU)治疗时间、住院时间均较对照组明显缩短〔ICU治疗时间(d):5.71±2.22比6.86±2.99,住院时间(d):15.50±6.39比17.02±5.70〕,病死率降低〔21.27%(30/141)比32.33%(43/133),P<0.05〕。结论在西医基础上加用血必净治疗复杂腹腔感染脓毒症,可减轻机体炎凝反应,有炎凝并治的功效,临床获益良好。Objective To investigate the effect of Xuebijing injection on the inflammatory and coagulation response of complicated intra-abdominal infection by sepsis.Methods A retrospective study was conducted.A total of 274 patients with complicated intra-abdominal infection by sepsis admitted to Yidu Central Hospital of Weifang from June 2020 to July 2023 were enrolled.According to whether Xuebijing was used or not,the patients were divided into an observation group(141 cases)and a control group(133 cases).The patients in both groups were treated with conventional western medicine,and those in the observation group were additionally given Xuebijing(Xuebijing injection 100 mL in 0.9%NaCl solution 100 mL via intravenous infusion,twice per day for a continuous application of 5 days).The differences of clinical prognosis and the serum levels of inflammatory indicators interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein(CRP)and endotoxin and coagulation indexes D-dimer,fibrinogen(FIB),prothrombin time(PT)and activated partial thromboplastin time(APTT)before treatment and on the 2nd,3rd,5th day respectively after treatment were compared,and the clinical prognosis was observed.Results There were no significant differences in the indexes of inflammation and coagulation function between the two groups before treatment.With the extension of therapy duration,following treatment in two groups,the serum levels of inflammatory indicators and coagulation indexes(D-dimer,FIB)decreased,as did coagulation indexes(PT,APTT),reaching the lowest levels on the 5th day.The inflammatory markers and coagulation indexes of observation group were significantly lower than those of control group[IL-6(ng/L):18.89±8.22 vs.24.59±10.39,PCT(μg/L):0.30±0.16 vs.0.52±0.20,CRP(mg/L):13.13±6.54 vs.28.87±8.66,endotoxin(kEU/L):0.17±0.06 vs.0.22±0.08,D-dimer(mg/L):1.75±0.61 vs.1.96±0.77,FIB(g/L):2.50±0.78 vs.3.10±0.94,PT(s):14.16±1.90 vs.15.05±1.46,APTT(s):34.52±5.40 vs.36.21±4.72,both P<0.05].The intensive care unit(ICU)stay time and total

关 键 词：复杂性腹腔感染 血必净注射液 脓毒症 炎凝反应 炎凝并治 

分 类 号：R631[医药卫生—外科学]