血必净注射液对肠外瘘合并脓毒症辅助治疗临床探究.doc

血必净注射液对肠外瘘合并脓毒症辅助治疗临床探究【摘要】目的:探讨血必净注射液在辅助治疗肠外瘘合并脓毒症的发热、减轻炎症反应、降低病情危重程度等方面的作用。方法:将我院2006.10～2010.09收治的确诊为肠外瘘合并脓毒症的30例患者随机分为实验组和对照组各15例。在相同的常规西医治疗基础上，实验组加用血必净注射液100ml,VD，50ml/h,Bid，疗程7d。对两组所有患者治疗前后进行T、WBC、N%、IL-6和TNF-a、APACHEⅡ评分。患者28天转归情况进行比较分析。结果:经一疗程7天治疗后两组患者T、WBC、N%、IL-6和TNF-a水平、APACHEⅡ评分较疗前均有改善，差异有统计学意义（p0.05）。结论: 血必净注射液辅助治疗肠外瘘合并脓毒症患者具有显著的退热作用，能调节脓毒症患者外周血白细胞、中性粒细胞水平，能降低脓毒症炎症因子IL-6、TNF-a的水平，可改善脓毒症患者的炎症反应；能改善患者APACHEⅡ评分，对改善脓毒症患者的病情严重程度有一定的辅助治疗作用，为早期救治赢得宝贵时机，其作用机制可能与减轻炎症反应有关。但未能降低肠外瘘合并脓毒症患者28天后的死亡率，血必净注射液作用机制有待进一步深入探讨。 【关键词】肠外瘘;脓毒症 血必净注射液 IL-6;TNF-a;APACHEⅡ评分 【中图分类号】R631 【文献标识码】A 【文章编号】1008-6455（2010）11-0026-02 Xuebijing enterocutaneous fistula combined injection on clinical study of adjuvant treatment of sepsis Wu DezhuChen HuanghuiLin YudongGao Yuan 【Abstract】Objective: To investigate the blood will be a net injection in adjuvant treatment of sepsis, enterocutaneous fistula combined heat and reduce inflammation, reduce the severity of illness and other aspects of the role. Methods: 2006.10 ~ 2010.09 admitted to our hospital’s merger enterocutaneous fistula diagnosed 30 cases of sepsis were randomly divided into experimental and control group 15 cases. Conventional western medicine in the same basis, the experimental group received Xuebijing injection 100ml, VD, 50ml / h, Bid, treatment 7d. All patients in both groups before and after treatment T, WBC, N%, IL-6 and TNF-a, APACHE Ⅱ score. 28-day outcomes in patients with a comparative analysis of the situation. Results: After a course of 7 days after treatment, both groups T, WBC, N%, IL-6 and TNF-a levels, APACHE Ⅱ score was improved compared with before treatment, the difference was statistically significant (p 0.05). Conclusion: Xuebijing Injection in Treatment of enterocutaneous fistula in patients with sepsis combined with a significant cooling effect, can regulate peripheral leukocytes in patients with sepsis, neutrophil levels, can reduce the inflammatory cytokines IL-6 in sepsis， TNF-a levels