血必净治疗大肠癌合并肠梗阻术后患者脓毒症19例

Clinical efficacy of Xuebijing injection in treating postoperative sepsis of colorectal carcinoma patients with intestinal obstruction: an analysis of 19 cases

目的:评价血必净辅助治疗大肠癌合并肠梗阻术后患者脓毒症的临床疗效.方法:收集我院ICU病房内诊断为脓毒症的大肠癌合并肠梗阻术后患者36例,随机分为治疗组19例和对照组17例.对照组给予常规抗炎治疗;治疗组在此基础上加用血必净注射液100mL,2次/d,疗程7d.检测肿瘤坏死因子(TNF-α)、白介素(IL-6)、急性生理和慢性健康状况评分Ⅱ(APACHE Ⅱ)、白细胞及中性粒细胞百分比.结果:治疗组第7天TNF-α、IL-6、APACHE Ⅱ、白细胞及中性粒细胞百分比与对照组比较(325.33±168.49ng/L vs 432.34±154.89ng/L,26.32±13.65ng/L vs 35.77±15.86ng/L,7.3±1.3×109/L vs 10.2±2.2×109/L,76.4%±10.3% vs 84.8%±8.0%,8.8±4.5 vs 13.3±4.4,均P<0.05),有统计学差异;治疗组患者最终死亡率较对照组显著下降(0.05% vs 0.30%,P<0.05),差别有统计学意义.结论:大肠癌合并肠梗阻术后脓毒症患者在常规抗炎基础上加用血必净注射液,改善症状,降低死亡率.

AIM： To evaluate the clinical efficacy of Xuebijing injection in treating postoperative sepsis of colorectal carcinoma patients with intestinal obstruction. METHODS： Thirty-six colorectal carcinoma patients with intestinal obstruction were randomly divided into control group （n = 17） and treatment group （n = 19）. The control group received routine anti-inflammatory treatment while the treatment group received Xuebijing injection in addition to routine anti-inflammatory treatment, 100 mL a time, twice a day for one course of 7 days. Then the tumor necrosis factor-α （TNF-α）, interleukin-6 （IL-6） level, percentages of WBC and the neutrophil and APACHEⅡscore were measured and compared. RESULTS： Compared with the control group, there were significant differences in TNF-α, IL-6 level, APACHEⅡscore, percentages of WBC andneutrophil in the treatment group at d 7 （325.33 ± 168.49 ng/L vs 432.34 ± 154.89 ng/L, 26.32 ± 13.65 ng/L vs 35.77 ± 15.86 ng/L, 7.3 ± 1.3 × 10^9/ L vs 10.2 ± 2.2 × 10^9/L, 76.4% ± 10.3% vs 84.8% ± 8.0%, 8.8 ± 4.5 vs 13.3 ± 4.4, all P 〈 0.05）. Death rate decreased significantly in the treatment group （0.05% vs 0.30%, P 〈 0.05）. CONCLUSION： Xuebijing injection in combination with routine anti-inflammatory therapy can effectively improve symptoms and decrease death rate in critical colorectal carcinoma patients with intestinal obstruction.