摘要
目的探讨血必净注射液在重症急性胰腺炎并发脓毒血症患者中的临床应用效果。方法选取2016年6月至2017年12月在三亚市人民医院重症医学科住院治疗的重症急性胰腺炎并发脓毒血症患者79例,按随机数表法分为观察组41例和对照组38例。两组均予抗重症急性胰腺炎并发脓毒血症的对症治疗,并在此基础上,观察组应用血必净注射液,对照组予生理盐水替换,连续治疗7 d,治疗结束后比较两组患者的临床疗效、血清C反应蛋白(CRP)及白细胞(WBC)水平、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ评分)、手术率、凝血和免疫功能。结果治疗7 d结束时,观察组患者的治疗显效率为48.78%,临床治疗总有效率为92.68%,均明显高于对照组的23.68%和86.84%,差异均有统计学意义(P<0.05);观察组患者的血清WBC为(10.98±2.23)×109/L、CRP为(10.73±3.85) mg/L、APACHEⅡ评分为(6.03±1.55)分、手术率为12.19%,分别与对照组的(12.65±3.37)×109/L、(14.98±5.64) mg/L、(9.46±2.58)分和34.21%比较,差异均有统计学意义(P<0.05);观察组患者的凝血酶原时间(PT)(11.38±1.46) s、活化部分凝血活酶时间(APTT)(40.82±6.98) s、凝血酶时间(TT)(13.86±2.08) s和纤维蛋白原(FIB)(3.34±0.75) g/L,分别与对照组的(14.41±1.57) s、(37.33±6.86) s、(16.42±2.15) s和(2.75±0.89) g/L比较,差异均有统计学意义(P<0.05);观察组患者的B细胞(23.02±5.38)%、NK细胞(22.53±5.75)%和CD3+(49.85±8.78)%、CD4+(27.56±6.03)%、CD8+T细胞(21.74±5.53)%比例及CD4+/CD8+值(1.97±0.72),分别与对照组的(20.46±5.85)%、(18.78±6.49)%和(45.67±9.13)%、(24.75±6.48)%、(18.96±6.39)%及(1.51±0.77)比较,差异均有统计学意义(P<0.05)。结论重症急性胰腺炎并发脓毒血症患者应用血必净注射液治疗具有良好的抗炎、抗凝及调节机体免疫能力的作用,其临床疗效较肯定。
Objective To explore the clinical application effect of Xuebijing injection in patients with severe acute pancreatitis complicated with sepsis. Methods From June 2016 to December 2017, 79 patients with severe acute pancreatitis complicating sepsis were selected from Department of Critical Care Medicine, the People's Hospital of Sanya City, which were assigned into 41 patients in the observation group and 38 patients in the control group by random number table. Based on symptomatic treatment, the patients in the observation group were treated with Xuebijing injection, and those in the control group were given saline instead, both continuously for 7 d. Then the clinical efficacy, serum C-reactive protein (CRP), and white blood cell (WBC) levels, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) score, surgical rate, coagulation and immune function of the two groups were compared. Results After treatment, the markedly effective rate and the total effective rate in the observation group were 48.78% and 92.68% , which were significantly higher than 23.68% and 86.84% in the control group (P<0.05). The serum WBC, CRP, APACHEⅡ score, and surgical rate were (10.98±2.23)×109/L, (10.73±3.85) mg/L, (6.03±1.55), and 12.19% in the observation group, versus (12.65±3.37)×109/L, (14.98±5.64) mg/L, (9.46±2.58), and 34.21% in the control group (P<0.05). The prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (FIB) were (11.38±1.46) s, (40.82±6.98) s, (13.86±2.08) s, (3.34±0.75) g/L in the observation group, versus (14.41±1.57) s, (37.33±6.86) s, (16.42±2.15) s, and (2.75±0.89) g/L in the control group (P<0.05). The B cells, NK cells, CD3+, CD4+, CD8+ T cells levels, and CD4+/CD8+ value were (23.02±5.38)%, (22.53±5.75)%, (49.85±8.78)%, (27.56±6.03)%, (21.74± 5.53)%, and (1.97±0.72) in the observation group, versus (20.46±5.85)%, (18.78±6.49)%, (45.67±9.13)%, (24.75± 6.48)%, (18.96±6.39)%, and (1.51±0.77) in the control group (P<0.05). Conclusion For patients with severe acute pancreatitis complicating sepsis, Xuebijing injection has good anti-inflammatory, anti-coagulant effect, and can regulate the immune ability of the body.
作者
纪新尊
胡清甫
张尤帅
JI Xin-zun;HU Qing-fu;ZHANG You-shuai(Department of Critical Care Medicine, the People's Hospital of Sanya City, Sanya 572000, Hainan, CHINA)
出处
《海南医学》
CAS
2018年第23期3321-3324,共4页
Hainan Medical Journal
关键词
血必净注射液
重症急性胰腺炎
脓毒血症
疗效
Xuebijing injection
Severe acute pancreatitis
Sepsis
Curative effect
