乌司他丁联合连续性血液净化治疗重症脓毒症的临床效果

秦立博1 ，李忠义1 ，李华1 ，范小强1，刘红刚1 ，董向梅1 ，贾文元2*

（1.陕西省凤翔县医院急诊科，陕西 宝鸡，721400；2.第四军医大学附属西京医院急诊科，陕西 西安，710023）

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摘要：

目的 探讨乌司他丁联合连续性血液净化治疗重症脓毒症的临床效果。方法 将我院急诊科2016 年1 月至2017 年5 月 收治的76 例重症脓毒症患者作为研究对象，根据治疗方法分为两组，各38 例。血液净化组采用连续性血液净化治疗，血液 净化+药物组采用乌司他丁联合连续性血液净化治疗。比较两组患者的治疗效果。结果 血液净化+药物组患者的治疗总有效 率为94.73%，显著高于血液净化组的76.32%（P<0.05）。干预后，血液净化+药物组的CRP、白细胞数量优于血液净化组，症状 消失时间、住院时间均短于血液净化组（P<0.05）。结论 乌司他丁联合连续性血液净化对重症脓毒症的治疗效果确切，可有 效改善患者的血清学各指标水平，加速症状消退，缩短住院时间，改善患者预后。

关键词：乌司他丁；连续性血液净化；重症脓毒症

中图分类号：R459.7文献标志码：A文章编号：2096-1413(2018)06-0011-02

Clinical effect of ulinastatin combined with continuous blood purification on severe sepsis
QIN Li-bo 1, LI Zhong-yi 1, LI Hua1, FAN Xiao-qiang1, LIU Hong-gang1, DONG Xiang-mei 1, JIA Wen-yuan 2 *
(1. Emergency Department, the Hospital of Fengxiang County, Baoji 721400; 2. Emergency Department, Xijing Hospital, the Affiliated Hospital of the Fourth Military Medical University, Xi``an 710023, China)

ABSTRACT: Objective To investigate the therapeutic effect of ulinastatin combined with continuous blood purification on severe sepsis. Methods Seventy-six patients with severe sepsis admitted in the emergency department of our hospital from January 2016 to May 2017 were selected and divided into two groups according to the treatment methods, with 38 cases in each group. Blood purification group was treated with continuous blood purification treatment, blood purification+ drug group was treated with ulinastatin combined with continuous blood purification treatment. The clinical effects between the two groups were compared. Results The total effective rate of the blood purification+drug group was 94.73%, which was higher than 76.32% of the blood purification group (P<0.05). After treatment, CRP and white blood cell count in the blood purification+drug group were better than those in the blood purification group, the symptom disappearance time and hospital stays were shorter than those in the blood purification group (P <0.05). Conclusion Ulinastatin combined with continuous blood purification is effective in the treatment of severe sepsis, which can effectively improve the serum index, accelerate the symptoms subsided, shorten the hospitalization time and improve the prognosis of the patients.
KEYWORDS: ustodin; continuous blood purification; severe sepsis

参考文献：
[1] 莫必华,邓石荣,陈少武,等.乌司他丁联合连续性血液净化对严重脓毒血症患者D-二聚体和降钙素原的影响[J].岭南急诊医学杂 志,2016,21(1):10-12,29.
[2] 晁亚丽,胡伟伟,耿晓娟,等.乌司他丁联合连续性血液净化在严重 脓毒血症患者中的应用[J].中国继续医学教育,2016,8(31):149-150.
[3] 王瑞雪.血必净联合乌司他丁治疗重症脓毒症的疗效观察[J].临床医学研究与实践,2016,1(4):12.
[4] 张丽,丛树国,李和翠,等.连续性血液净化联合免疫调理治疗脓毒症的临床研究[J].齐齐哈尔医学院学报,2010,31(10):1532-1533.
[5] 叶小玲,陶珮,张锐,等.乌司他丁联合连续性肾脏替代治疗对老年脓毒症患者肠黏膜屏障功能的影响评价[J].国际医药卫生导报,2017,23(1):4-12.
[6] 何浩,胡亮,何彩霞,等.乌司他丁联合连续性血液净化治疗重症脓毒症临床研究[J].现代生物医学进展,2011,11(17):3334-3338.
[7] 赵梦雅,李昂,张淑文,等.参麦注射液及乌司他丁对重症脓毒症患者微循环的影响[J].首都医科大学学报,2012,33(3):297-300.