乌司他丁联合血必净治疗脓毒血症的疗效

Effects of Ulinastatin Combined with Xuebijing on Pyemia

目的探讨乌司他丁联合血必净治疗脓毒血症的临床疗效和安全性。方法将60例脓毒血症患者按入院的先后顺序分为观察组和对照组,每组30例。2组均根据细菌培养及药敏试验结果应用抗生素进行抗感染治疗,根据患者的血液生化检测指标及血气分析结果及时调整水、电解质紊乱及酸碱平衡。同时,给予肠内营养支持和肠外营养支持治疗。在此基础上,观察组采用乌司他丁和血必净注射液治疗。观察2组治疗前后肺组织中IL-6、TNF-α水平、住院时间、康复及死亡的情况,并对2组治疗前后进行急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)评分。结果观察组治疗后肺组织中IL-6、TNF-α水平、APACHEⅡ得分、住院时间和病死率均明显低于对照组(P<0.05或P<0.01),康复率明显高于对照组(P<0.05)。结论乌司他丁联合血必净治疗脓毒血症疗效显著,并能改善免疫功能。

Objective To investigate the clinical efficacy and safety of combined treatment with ulinastatin and Xuebijing in patients with pyemia. Methods Sixty patients with pyemia were divided into observation group and control group according to the order of admission ,with 30 patients in each group. Antibiotics were used for anti-infective therapy according to the results of bacterial culture and drug susceptibility test, and water, electrolyte and acid-base balance disorders were regulated according to the results of biochemical detection and blood gas analysis. Moreover, enteral and parenteral nutrition support was given in all patients. In addition,patients in observation group were treated with ulinastatin and Xuebijing injection. Levels of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in lung tissues and scores of acute physiology and chronic health evaluation Ⅱ （APACHE Ⅱ ） were determined before and after treatment. Furthermore, hospital stay ,recovery rate and mortality were recorded in both groups. Results Compared with control group,levels of IL-6 and TNF-α,APACHE H scores,hospital stay and mortality decreased and recovery rate increased in observation group （P〈0.05 or P〈0.01 ）. Conclusion The ulinastatin combined with Xuebijing is an effective treatment and can improve immunological function in patients with pyemia.