血必净注射液联合亚胺培南西司他丁治疗腹腔重症感染的临床观察

Clinical Observation of Xuebijing Injection Combined with Imipenem and Cilastatin in the Treatment of Severe Abdominal Infection

目的:观察血必净注射液联合亚胺培南西司他丁治疗腹腔重症感染的临床疗效、安全性及对患者血浆内毒素、炎症因子的影响。方法:选取2013年4月-2016年4月在我院接受治疗的腹腔重症感染患者100例,按随机数字表法分为观察组和对照组,各50例。对照组患者给予注射用亚胺培南西司他丁钠0.5 g加入0.9%氯化钠注射液500 m L中,ivgtt(时间≥40 min),q12 h;观察组患者在对照组基础上间隔8 h给予血必净注射液100 m L加入0.9%氯化钠注射液500 m L中,ivgtt,bid。两组患者均治疗5~7d。比较两组患者治疗前后血浆内毒素和炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-6/IL-10]水平及临床疗效,并记录不良反应发生情况。结果:治疗前,两组患者血浆内毒素和炎症因子水平比较,差异均无统计学意义(P>0.05);治疗后,两组患者血浆内毒素和炎症因子水平均显著下降,且观察组水平显著低于对照组,差异均有统计学意义(P<0.05)。观察组患者优良率为98.00%,显著高于对照组的78.00%,差异有统计学意义(P<0.05)。两组患者均未见明显不良反应发生。结论:血必净注射液联合亚胺培南西司他丁治疗腹腔重症感染疗效显著,能有效控制患者内毒素以及炎症因子的释放,且安全性较高。

OBJECTIVE：To observe clinical efficacy and safety of Xuebijing injection combined with imipenem and cilastation in the treatment of severe abdominal infection,and its effects on plasma endotoxin and inflammatory factors. METHODS：During Apr. 2013-Apr. 2016,100 patients with severe abdominal infection in our hospital were divided into observation group and control group according to random number table,with 50 cases in each group. Both groups were given Imipenem and cilastation sodium for injection 0.5 g added into 0.9% Sodium chloride injection 500 m L,ivgtt（≥40 min）,q12 h. Eight hours later,observation group was additionally given Xuebijing injection 100 m L added into 0.9% Sodium chloride injection 500 m L,ivgtt,bid;Both groups were treated for 5-7 d. The levels of plasma endotoxin and inflammatory factors（TNF-α,IL-6,IL-6/IL-10）were compared in 2 groups before after treatment,and clinical efficacies and the occurrence of ADR was recorded. RESULTS：Before treatment,there was no statistical significance in plasma endotoxin or inflammatory factor levels between 2 groups（P〈0.05）. After treatment,plasma endotoxin and inflammatory factor levels of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance（P〈0.05）. The excellent and good rate of observation group was 98.00%,which was significantly higher than 78.00%,with statistical significance（P〈0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS：Xuebijing injection combined with imipenem and cilastation show significant therapeutic efficacy for severe abdominal infection,can effectively control the release of endotoxin and inflammatory factors with good safety.