摘要
目的 探讨血必净注射液联合胃肠道去污对脓毒症合并胃肠功能损伤患者的临床价值。方法 纳入2023年1月至2023年10月于重庆大学附属涪陵医院重症医学科接受治疗的84例脓毒症患者进行随机对照试验,采用随机数字表法将其分为试验组和对照组,每组42例。两组患者均接受集束化治疗,根据用药方案不同分为对照组(常规治疗)和试验组(常规治疗+血必净注射液+大黄肠道去污),治疗均持续1周。比较两组患者治疗前以及治疗1周后炎症因子水平、血流动力学参数、临床疗效,并观察记录治疗期间的不良反应。结果 治疗1周后,试验组TNF-α、PCT、STAT-3、JAK-2水平和平均心率均低于对照组(P<0.05),平均动脉压高于对照组(P<0.05),两组中心静脉压差异无统计学意义(P>0.05);对照组的急性生理学与慢性健康状况评价系统Ⅱ(APACHEⅡ)评分和胃肠功能障碍评分高于试验组(P<0.05);对照组的腹痛、腹胀缓解时间、肠鸣音恢复时间均长于试验组(P<0.05);试验组ICU住院时间及机械通气时间短于对照组(P<0.05);治疗期间,两组不良反应发生率差异无统计学意义(P>0.05)。结论 采用血必净联合肠道去污治疗重症脓毒症合并胃肠功能障碍患者,可降低其炎症水平与病情严重程度,促进胃肠道功能恢复,优化血流动力学参数,缩短ICU住院时间,且不会增加不良反应。
Objective To explore the clinical value of Xuebijing injection combined with selective decontamination of digestive tract(SDD)for patients with sepsis and gastrointestinal dysfunction(GD).Methods A total of 84 patients with sepsis treated in the Department of Critical Care Medicine of Chongqing University Fuling Hospital from January 2023 to October 2023 were included in the randomized controlled trial.They were randomly divided into an experimental group(n=42)and a control group(n=42)by random number table method.Sepsis bundle strategy was used in both groups.And the control group received conventional treatment,while the experimental group was additionally given Xuebijing injection and SDD on the basis of conventional treatment.The treatment lasted for 1 week.The levels of inflammatory factors,hemodynamic parameters before treatment and 1 week after treatment and clinical efficacywere compared between the two groups.The adverse reactions during treatment were observed and recorded.Results After 1 week of treatment,the levels of TNF-α,PCT,STAT-3 and JAK-2 and average heart rate in the experimental group were lower than those in the control group(P<0.05).The mean arterial pressure in the experimental group was higher than that in the control group(P<0.05).There was no significant difference in central venous pressure between the two groups(P<0.05).The scores of Acute Physiology and Chronic Health Evaluation II(APACHE-II)and gastrointestinal dysfunction in the control group were higher than those in the experimental group(P<0.05).The relief time of abdominal pain and distension,and the recovery time of bowel sounds in the control group were longer than those in the experimental group(P<0.05).The duration of ICU stay and mechanical ventilation in the experimental group were shorter than those in the control group(P<0.05).During treatment,there was no significant difference in the incidence of adverse reactions between the two groups(P<0.05).Conclusion Xuebijing injection combined with SDD in the treatment of severe sepsis complicated with GD can reduce the level of inflammation and the severity of the disease,promote the recovery of gastrointestinal function,optimize hemodynamic parameters,and shorten the length of ICU stay without increasing the adverse reactions.
作者
蒋昌华
吴成芳
舒艾娅
简万均
Jiang Changhua;Wu Chengfang;Shu Aiya;Jian Wanjun(Department of Critical Care Medicine,Chongqing University Fuling Hospital,Chongqing 408000,China;Department of Pathology,Chongqing University Fuling Hospital,Chongqing 408000,China)
出处
《成都医学院学报》
CAS
2024年第3期432-436,共5页
Journal of Chengdu Medical College
基金
重庆市自然科学基金项目(No:cstc2021jcyj-msxmX0628)
重庆市卫生健康委员会中医药科研项目(No:2023WSJK139)。
关键词
血必净注射液
肠道去污
脓毒症
Xuebijing injection
Selective decontamination of digestive tract
Sepsis
