摘要
目的 观察不同剂量血必净注射液对脓毒症患者炎症指标、器官替代治疗及临床预后的影响.方法 选择 2019 年 11 月至 2022 年 3 月湖北省中医院重症医学科收治的 90 例脓毒症患者作为研究对象.按随机数字表法将患者分为常规治疗组、血必净小剂量组、血必净大剂量组,每组 30 例.常规治疗组按脓毒症指南进行常规治疗;血必净小剂量组在常规治疗基础组上加用血必净注射液 100 mL,每 12h1 次,连续 7d;血必净大剂量组在常规治疗基础上加用血必净注射液 100 mL,每 8h1 次,连续 7d.比较 3 组患者治疗前及治疗 3 d、7d C-反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)清除率(PCTc)的差异,并观察 3 组有创机械通气时间、持续血液净化时间、28d生存率和不良反应发生情况.结果 随治疗时间延长,3 组CRP和IL-6 水平均逐渐降低,治疗 7d达最低水平,且以血必净大剂量组较血必净小剂量组和常规治疗组降低更显著[CRP(mg/L):93.43±10.41 比 102.03±13.98、109.47±7.08,IL-6(ng/L):159.41±6.56 比175.65±11.37、177.93±4.69,均P<0.05];治疗后PCTc均明显升高,以血必净大剂量组PCTc较血必净小剂量组和常规治疗组升高更显著[(86.47±3.01)%比(80.90±4.93)%、(72.83±6.69)%,均P<0.05].血必净大剂量组有创机械通气时间、持续血液净化时间均较血必净小剂量组及常规治疗组明显缩短[有创机械通气时间(h):95.80±32.32 比 106.96±32.87、113.65±24.54,持续血液净化时间(h):43.74±16.65 比 55.54±13.51、61.71±9.53,均P<0.05],血必净大剂量组 28d生存率较血必净小剂量组和常规治疗组明显升高(83.3%比73.3%、66.7%,均P<0.05).结论 血必净注射液可显著降低脓毒症患者的炎症水平,缩短机械通气时间和血液净化时间,改善患者预后,以血必净大剂量组的效果更为明显,且不影响治疗的安全性.
Objective To observe the effects of different doses of Xuebijing injection on inflammatory indexes,organ replacement therapy,and clinical prognosis of patients with sepsis.Methods Ninety cases of septic patients admitted to the department of intensive care unit of Hubei Provincial Hospital of Traditional Chinese Medicine from November 2019 to March 2022 were selected as the study subjects.According to the random number table method,they were divided into the conventional treatment group,the Xuebijing small dose group,and the Xuebijing high dose group,with 30 casesin each group.The conventional treatment group was treated conventionally according to the sepsis guidelines;the Xuebijing small dose group was treated with Xuebijing injection 100 mL,pumped intravenously once every 12 hours for 7 days;the Xuebijing high dose group was treated with Xuebijing injection 100 mL,pumped intravenously once every 8 hours for 7 days.The differences in C-reactive protein(CRP),interleukin-6(IL-6),and procalcitonin(PCT)clearance(PCTc)before treatment and at 3 days and 7 days of treatment were compared among the three groups,and the duration of invasive mechanical ventilation,duration of continuous blood purification,28-day survival rate and occurrence of adverse effects were observed in the three groups.Results The CRP and IL-6 levels gradually decreased in all three groups with the extension of treatment time,reaching the lowest level in 7 days of treatment,and the decrease was more significant in the Xuebijing high dose group than in the Xuebijing low dose group and conventional treatment group[CRP(mg/L):93.43±10.41 vs.102.03±13.98,109.47±7.08,IL-6(ng/L):159.41±6.56 vs.175.65±11.37,177.93±4.69,all P<0.05],PCTc was significantly increased after treatment,and the increase in PCTc was more significant in the Xuebijing high dose group than in the Xuebijing low dose group and the conventional treatment group[(86.47±3.01)%vs.(80.90±4.93)%,(72.83±6.69)%,both P<0.05].The duration of invasive mechanical ventilation and continuous
作者
程小彬
李刚
卿慧玲
Cheng Xiaobin;Li Gang;Qin Huiling(Department of Intensive Care Unit,Hubei Provincial Hospital of Traditional Chinese Medicine,Wuhan 43006l,Hubei,China;不详)
出处
《中国中西医结合急救杂志》
CAS
CSCD
北大核心
2023年第2期132-135,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
关键词
血必净注射液
脓毒症
炎症指标
机械通气
血液净化
预后
Xuebijing injection
Sepsis
Inflammatory index
Mechanical ventilation
Blood purification
Prognosis
