血必净联合乌司他丁治疗ICU脓毒症患者的效果分析

Analysis of the Effect of Hemodiazepine Combined With Ostrychnine on Patients With ICU Sepsis

目的研究血必净联合乌司他丁治疗的ICU脓毒症患者的疗效和安全性。方法选取我院2015年10月—2017年5月收治的符合实验标准的ICU脓毒症患者126例作为研究对象,将其随机分配成乌司他丁组、血必净组以及血必净联合乌司他丁组。在常规治疗的基础上,一组加用乌司他丁20万U,一组加用血必净100 ml,一组加乌司他丁20万U联合血必净100 ml。三组患者均静脉滴注,每次12小时,7天为1个疗程。治疗前及治疗后的第4天和第8天分别抽取静脉血,测定检测LPS、TNF-α、IL-6和PCT的浓度,并统计ICU脓毒症患者的住院时间、机械通气时间和28天的存活率。结果三组患者治疗前各项数据比较,差异均不具有统计学意义(P>0.05);三组患者治疗4天、8天后PCT、LPS、IL-6、TNF-α水平均较治疗前下降,治疗前后对比,差异均具有统计学意义(P<0.05);且治疗8天后PCT、LPS、IL-6、TNF-α水平均较治疗4天后下降,差异均具有统计学意义(P<0.05);且治疗4天、8天后血必净+乌司他丁治疗组下降幅度大于其他两组,差异均具有统计学意义(P<0.05)。乌司他丁组和血必净组的机械通气时间和ICU住院时间均高于血必净+乌司他丁组,而血必净+乌司他丁组的28 d存活率高于其他两组,差异均具有统计学意义(P<0.05)。结论使用血必净联合乌司他丁治疗的ICU脓毒症患者相对于单独使用血必净或者乌司他丁的疗效好。

Objective To study the efficacy and safety of Xuebijing combined with ulinastatin in the treatment of ICU sepsis. Methods 126 patients with ICU sepsis admitted in our hospital from October 2015 to May 2017 were selected to be randomly assigned to the Ulinastatin group, Xuebijing group and Xuebijing combined with ulinastatin group. On the basis of routine treatment, one group was added with ulinastatin 200 thousand U, one group added with Xuebijing 100 ml, a group of 200 thousand U combined with Xuebijing 100 ml. Three groups of patients were intravenous drip, 12 hours in each time, 7 days for 1 course. Venousblood was collected before and fourth days and eighth days after treatment respectively. The concentrations of LPS, TNF-α, IL-6 and PCT were detected. The hospitalization time, mechanical ventilation time and 28 days survival rate of ICU patients with sepsis were also statistically analyzed.Results There was no statistically significant difference in the data between the three groups before treatment（P〈0.05）. The levels of PCT, LPS, IL-6 and TNF-α in the three groups were all lower than those before treatment for4 and 8 days. The difference was statistically significant（P〈0.05） before and after treatment. After 8 days of treatment, the levels of PCT, LPS, IL-6 and TNF-alpha were all lower than those of 4 days after treatment, and the differences were statistically significant（P〈0.05）. After treatment for 4 days and 8 days, Xuebijing combined Ulinastatin decreased significantly in the treatment group than those in the other two groups, and the differences were statistically significant（P〈0.05）. The mechanical ventilation time and ICU hospitalization time of the Ulinastatin group and Xuebijing group were higher than that of Xuebijing ＋ Ulinastatin group, while the 28 d survival rate of Xuebijing ＋ Ulinastatin group was higher than that of the other two groups, and the difference was statistically significant（P〈0.05）.Conclusion ICU sepsis patients treated with Xuebijing combined with ulinastatin have a better curative effect and lower mortality than those used alone.