低分子肝素钙治疗ICU脓毒症患者的效果观察

Effects of low molecular weight heparin calcium on sepsis patients in ICU

目的研究低分子肝素钙治疗重症加强护理病房(ICU)脓毒症患者的效果。方法抽取2018年1月至2020年12月商丘市第一人民医院收治的ICU脓毒症患者80例为研究对象,按照随机数字表法分为对照组(40例)和观察组(40例)。观察组采用常规及低分子肝素钙治疗,对照组采用常规治疗。两组均连续治疗7 d,并于治疗后7、28 d进行随访。比较两组治疗前及治疗后7 d血清C-反应蛋白(CRP)、降钙素原(PCT)、白细胞介素-6(IL-6)、血清超氧化物歧化酶(SOD)、丙二醛(MDA)、血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APPT)、纤维蛋白原(FIB)水平变化。比较分析两组ICU住院时间及治疗后28 d病死率。结果治疗后7 d,两组血清CRP、PCT、IL-6水平较治疗前降低,且观察组低于对照组(P<0.05)。治疗后7 d,两组血浆PT、APPT较治疗前缩短,观察组短于对照组(P<0.05)。治疗后7 d,两组血浆FIB水平较治疗前升高,且观察组高于对照组(P<0.05)。治疗后7 d,观察组SOD水平高于治疗前,对照组血清SOD水平低于治疗前,且观察组高于对照组(P<0.05)。治疗后7 d,观察组血清MDA水平低于治疗前,对照组血清MDA水平高于治疗前,且观察组低于对照组(P<0.05)。观察组与对照组ICU住院时间、治疗后28 d病死率比较差异未见统计学意义(P>0.05)。结论低分子肝素钙治疗ICU脓毒症可有效缓解患者临床症状,改善凝血功能,使血清CRP、PCT、IL-6、MDA含量下降,血清SOD含量上升,提高临床疗效。

Objective To study the effect of low molecular weight heparin calcium on patients with sepsis in intensive care unit(ICU).Methods A total of 80 patients with sepsis treated in ICU of Shangqiu First People’s Hospital from January 2018 to December 202 were selected as study subjects.And they were divided into control group(40 cases)and observation group(40 cases)by random number table method.The observation group was given conventional and low molecular weight heparin calcium treatment,and the control group was given conventional treatment.Both groups received treatment for 7 consecutive days,and were followed up on 7 and 28 days after treatment.The preoperative and 7-day postoperative levels of serum C-reactive protein(CRP),procalcitonin(PCT),interleukin-6(IL-6),superoxide dismutase(SOD),malondialdehyde(MDA),plasma prothrombin time(PT),activeated partial thromboplasting time(APPT),fibrinogen(FIB)were comapred between the two groups.And the length of ICU hospitalization,and the 28-day case fatality rate after treatment were compared between the two groups.Results Seven days after treatment,the levels of serum CRP,PCT and IL-6 decreased in the two groups,compared with those before treatment,and the levels of observation group were lower than those of control group(P<0.05).The levels of plasma PT and APPT were decreased in the two groups 7 days after treatment,compared with before treatment,and these indexes of the observation group were shorter than those of the control group(P<0.05).The 7-day postoperative plasma FIB content of the two groups increased,compared with before treatment,and the 7-day postoperative content of the observation group was higher than that of the control group(P<0.05).Compared with preoperative levels,the 7-day postoperative SOD content of the observation group increased,while the content of control group decreased,and 7-day postoperative SOD content of the observation group was higher than that of the control group (P<0.05).The 7-day postoperative serum MDA content decreased in the observation group,and increased in the control group,compared to preoperative content,and the 7-day postoperative serum MDA content of observation group was lower than that of the control group(P<0.05).There was no significant difference in ICU hospitalization or 28-day postoperative case fatality rate between the two groups(P>0.05).Conclusions Low molecular weight heparin calcium can effectively alleviate the clinical symptoms of patients with ICU sepsis,improve blood coagulation function,reduce serum levels of CRP,PCT,IL-6,and MDA,increase serum SOD levels,and improve clinical efficacy.