血必净联合血液净化治疗脓毒血症多脏器衰竭的疗效观察  

Observation on efficacy of Xuebijing combined with blood purification in patients with sepsis and multiple organ failure

作　　者：陈向坤 CHEN Xiang-kun(Suqian First People's Hospital,Suqian 223800,China)

机构地区：[1]宿迁市第一人民医院,223800

出　　处：《中国实用医药》2024年第19期112-115,共4页China Practical Medicine

摘　　要：目的 探讨血必净联合血液净化对脓毒血症多脏器衰竭患者的临床疗效。方法 60例脓毒血症多脏器衰竭患者,根据随机数字表法分为对照组和观察组,每组30例。两组患者均按照国际脓毒血症治疗指南开展常规治疗,对照组患者在此基础上给予血液净化治疗,观察组患者在对照组基础上加用血必净治疗。比较两组患者治疗效果、住院情况以及治疗前后的炎性指标、血流动力学指标。结果 观察组治疗总有效率90.0%,高于对照组的66.7%,差异显著(P<0.05)。治疗后,两组患者降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均较治疗前有所下降,且观察组患者PCT(5.82±1.31)μg/L、CRP(21.46±5.27)mg/L、IL-6(180.5±10.74)ng/L均低于对照组的(8.39±2.73)μg/L、(38.62±4.80)mg/L、(290.3±11.37)ng/L,差异显著(P<0.05)。治疗后,两组患者心脏指数(CI)、平均动脉压(MAP)较治疗前均有所上升,体循环阻力指数(SVRI)较治疗前下降,且观察组患者CI(3.71±0.64)L/(min·m^(2))、MAP(93.16±8.54)mm Hg(1 mm Hg=0.133 kPa)高于对照组的(3.11±0.57)L/(min·m^(2))、(86.47±7.12)mm Hg, SVRI(2106.2±189.6)dyn·s·m^(2)/cm5低于对照组的(2397.4±206.4)dyn·s·m^(2)/cm5,差异显著(P<0.05)。观察组住院时间为(11.7±1.5)d,病死率为10.0%(3/30);对照组住院时间为(18.5±1.5)d,病死率为33.3%(10/30)。观察组患者住院时间显著短于对照组,病死率低于对照组,差异显著(P<0.05)。结论 血必净联合血液净化治疗脓毒血症多脏器衰竭,能纠正失衡的内环境,使患者生命体征得到稳定,提高其生存率,值得临床推广。Objective To explore the clinical efficacy of Xuebijing combined with blood purification in patients with sepsis and multiple organ failure.Methods 60 patients with sepsis and multiple organ failure were divided into a control group and an observation group according to random numerical table,with 30 cases in each group.Both groups of patients were treated according to the international sepsis treatment guidelines.On this basis,the control group received blood purification treatment,and the observation group added Xuebijing based on the control group.The treatment effect,hospitalization,inflammatory indicators and hemodynamic parameters before and after treatment were compared between the two groups.Results The total effective rate of 90.0%in the observation group was significantly higher than 66.7%in the control group(P<0.05).After treatment,the levels of procalcitonin(PCT),C-reactive protein(CRP)and interleukin-6(IL-6)in both groups were decreased compared with those before treatment;the observation group had PCT of(5.82±1.31)μg/L,CRP of(21.46±5.27)mg/L and IL-6 of(180.5±10.74)ng/L,which were lower than(8.39±2.73)μg/L,(38.62±4.80)mg/L and(290.3±11.37)ng/L in the control group;the difference was significant(P<0.05).After treatment,the cardiac index(CI)and mean arterial pressure(MAP)were increased,and the systemic vascular resistance index(SVRI)was decreased in both groups compared with those before treatment;the observation group had CI of(3.71±0.64)L/(min·m2)and MAP of(93.16±8.54)mm Hg(1 mm Hg=0.133 kPa),which were higher than(3.11±0.57)L/(min·m2)and(86.47±7.12)mm Hg in the control group;SVRI of(2106.2±189.6)dyn·s·m2/cm5 in the observation group was lower than(2397.4±206.4)dyn·s·m2/cm5 in the control group;the difference was significant(P<0.05).The length of hospital stay in the observation group was(11.7±1.5)d,and the fatality rate was 10.0%(3/30).The length of hospital stay in the control group was(18.5±1.5)d,and the fatality rate was 33.3%(10/30).The length of hospital stay of the obser

关 键 词：血必净 血液净化 脓毒血症 多脏器衰竭 

分 类 号：R459.7[医药卫生—急诊医学]