血必净注射液联合去甲肾上腺素治疗感染性休克的临床研究

Clinical observation of Xuebijing Injection combined with norepinephrine in treatment of septic shock

目的观察血必净注射液联合去甲肾上腺素治疗感染性休克的临床疗效。方法选取2013年8月—2015年3月东方市人民医院重症医学科收治的感染性休克患者66例,随机分为对照组和治疗组,每组各33例。对照组静脉滴注重酒石酸去甲肾上腺素注射液0.1μg/(kg·min),1次/d;治疗组在对照组基础上静脉滴注血必净注射液,100 m L/次,2次/d。两组均连续治疗14 d。观察两组的临床疗效,比较两组患者的血流动力学及炎性因子的变化。结果治疗后,对照组和治疗组的总有效率分别为81.82%、96.97%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者的心脏指数(CI)、平均动脉压(MAP)、中心静脉压(CVP)、血氧饱和度(Sp O2)及静脉血氧饱和度(SvO_2)明显升高,同组治疗前后差异有统计学意义(P<0.05);且治疗组这些观察指标的升高程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者的乳酸(LA)、C反应蛋白(CPR)及血清降钙素原(PCT)的水平均明显降低,同组治疗前后差异有统计学意义(P<0.05);且治疗组这些观察指标的降低程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论血必净注射液联合去甲肾上腺素治疗感染性休克具有较好的临床疗效,能抑制炎症反应,改善血流动力学,具有一定的临床推广应用价值。

Objective To observe the effect of Xuebijing Injection combined with norepinephrine in treatment of septic shock. Methods Patients（66 cases） with septic shock in Department of Intensive Care Unit of Dongfang People＇s Hospital from August 2013 to May 2015 were randomly divided into the control and treatment groups, and each group had 33 cases. Patients in the control group were iv administered with Noradrenaline Bitartrate Injection, infusion speed 0.1 μg/（kg·min）, once daily. Patients in the treatment group were iv administered with Xuebijing Injection on the basis of control group, 100 m L/time, twice daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the changes of hemodynamic indexes and inflammatory factors in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.82% and 96.97%, respectively, and there was difference between two groups（P〈0.05）. After treatment, CI, MAP, CVP, SpO2, and SvO2 in two groups were significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the levels of LA, CPR, and PCT in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Xuebijing Injection combined with norepinephrine has the clinical curative effect in treatment of septic shock, and inhibit inflammatory reaction, improve hemodynamics, which has a certain clinical application value.