中国医科大学学报

中国医科大学学报

中国医科大学学报

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乌司他丁、血必净联合治疗对烧伤后脓毒症凝血功能及全身炎性反应影响的临床研究

唐虹   

  1. 天津市第四医院烧伤科,天津300220
  • 收稿日期:2015-04-14 出版日期:2015-12-15 发布日期:2015-12-17
  • 作者简介:唐虹(1968 -),女,副主任医师,本科.E-mail:ths38@sina.com

Clinical Study on the Effects of Ulinastatin Injection Combined with Xuebijing on Coagulation Function and Systemic Inflammatory Response in Patients with Sepsis after Burn

TANG Hong   

  1. Department of Burn,The Fourth Hospital of Tianjin,Tianjin300220,China
  • Received:2015-04-14 Online:2015-12-15 Published:2015-12-17

摘要:

目的 观察乌司他丁(UTI)、血必净联合治疗对烧伤后脓毒症凝血功能及全身炎性反应的影响。方法 选择20091月至20141月入住我院烧伤科的符合脓毒症诊断的患者103例,随机分为2组:对照组(51例)和治疗组(52例)。已获得患者知情同意并签署知情同意书。对照组进行常规液体复苏、机械通气、肾替代、创面换药或手术,代谢营养支持等;治疗组在常规治疗基础上加用静脉滴注血必净(100 mL2/d)、乌司他丁(40U2/d),连用10 d2组患者分别于治疗前及治疗后13710 d行血常规、凝血功能及炎性反应指标[血浆脂多糖、肿瘤坏死因子α、白细胞介素6、白细胞介素10C-反应蛋白和降钙素原]检测。结果 2组治疗后凝血指标血纤维蛋白原降解产物、血浆纤维蛋白原浓度、血D-二聚体,血小板及炎性反应指标较治疗前均显著改善(P < 0.01);治疗组改善效果明显优于对照组,差异有统计学意义(P < 0.05);治疗7 d后治疗组炎性反应指标水平与对照组比较下降更加明显,差异有统计学意义(P < 0.05)。结论 血必净、乌司他丁联合治疗烧伤后脓毒症,可减轻全身炎性反应,改善血液高凝状态。

关键词: 乌司他丁, 血必净, 脓毒症, 炎性反应, 凝血功能

Abstract:

Objective To observe the effects of ulinastatinUTIand xuebijing on treatment of burns sepsis after coagulation and systemic inflammation. Methods A total of 103 patients diagnosed of sepsis in burn department of our hospital during 2009-01 - 2014-01 were recruited for the study and randomly divided into 2 groups. The control group51 casesreceived conventional fluid resuscitationmechanical ventilationrenal replacementwound dressing or operationmetabolic nutrition supportthe treatment group52 casesreceived vein infusion of xuebijing 100 mLbid on the basis of conventional therapyulinastatin 400 000 U intravenous dripbidfor 10 d. The blood routineblood coagulation function and inflammatory reaction index and plasma lipopolysaccharideLPS),tumor necrosis factor-alphaTNF-alpha),interleukin-6IL-6),interleukin-10 IL-10),C- reactive proteinCRPand procalcitoninPCTof the patients in each group were respectively detected before treatment and after treatment in the 13710 days. Results After treatment of coagulationindexes of blood fibrinogen degradation productFDP),plasma fibrinogenFIB),blood concentration of two D- dimerD-DT),platelet and inflammatory reaction index compared were significantly improved compare with those before treatment in both two groupsP < 0.01. In additionthe treatment group showed significantly better effects than the control groupand the difference was statistically significantP <0.05.7 d after treatment inflammation index levels in treatment group decreased more significantly compared with the control groupand the difference was significantP < 0.05. Conclusion  Combined application of xuebijingulinastatin with auxiliary treatment of post-burn sepsis can reduce the systemic inflammatory responseimprove blood hypercoagulable state.

Key words: ulinastatin, xuebijing, sepsis, inflammatory response, blood coagulation function

中图分类号: 

  • R644
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