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目的观察血必净注射液对严重脓毒症患者凝血功能的影响。方法将2009年8月—2012年12月天津市津南区咸水沽医院收治的48例严重脓毒症患者随机分为对照组和观察组各24例。对照组给予常规综合治疗,包括抗炎、抗感染、呼吸机辅助呼吸及脂肪乳、氨基酸、葡萄糖等营养支持及对症治疗。观察组在对照组基础上加用血必净注射液100ml+0.9%NaCl注射液200 ml静脉滴注,1次/12 h。两组均治疗12 d。观察两组治疗前和治疗后第4、8、12天的PT、APTT、FIB、Plt、D-D变化情况。计量资料采用t检验,P<0.05为差异有统计学意义。结果治疗前两组各项检测指标比较,差异均无统计学意义(均P>0.05)。治疗第8天,对照组PT[(18.59±5.78)s]、APTT[(40.45±5.02)s]、Plt[(147.60±38.69)×109/L]、D-D[(0.64±0.27)mg/L]与治疗前[(23.60±4.90)、(49.10±6.36)s、(93.10±36.88)×109/L、(0.98±0.25)mg/L]比较,差异均有统计学意义(均P<0.05);观察组[(14.70±4.12)、(36.96±4.11)s、(166.60±37.02)×109/L、(0.59±0.26)mg/L]与治疗前[(22.59±5.21)、(51.48±5.97)s、(97.45±43.01)×109/L、(0.99±0.23)mg/L]比较,差异均有统计学意义(均P<0.05)。治疗第12天,对照组PT[(16.89±4.21)s]、APTT[(36.00±4.52)s]、Plt[(159.80±33.69)×109/L]、D-D[(0.55±0.27)mg/L]与治疗前比较,差异均有统计学意义(均P<0.05);观察组[(13.60±3.90)、(30.55±4.38)s、(160.50±29.22)×109/L、(0.42±0.21)mg/L]与治疗前比较,差异均有统计学意义(均P<0.05)。治疗第8、12天,观察组PT、APTT、D-D改善情况均优于对照组,两组比较差异均有统计学意义(均P<0.05)。结论血必净注射液能改善严重脓毒症患者的凝血功能障碍,有利于治疗。
Objective To observe the effect of Xuebijing Injection on coagulation in patients with severe sepsis. Methods Forty-eight patients with severe sepsis admitted in Xianshuigu Hospital, Jinnan District, Tianjin from August 2009 to December 2012 were randomly divided into control group and observation group with 24 cases each. The control group was given conventional comprehensive treatment, including anti-inflammatory, anti-infective, ventilator-assisted breathing and fat emulsion, amino acid, glucose and other nutritional support and symptomatic treatment. On the basis of the control group, the observation group was given Xuebijing Injection 100ml + 0.9% NaCl injection 200ml intravenously once a day for 12 hours. Both groups were treated for 12 days. The changes of PT, APTT, FIB, Plt and D-D in the two groups before and 4, 8 and 12 days after treatment were observed. Measurement data using t test, P <0.05 for the difference was statistically significant. Results Before treatment, there was no significant difference between the two groups (all P> 0.05). The levels of PT [(18.59 ± 5.78) s], APTT (40.45 ± 5.02 s), Plt (147.60 ± 38.69) × 109 / L and DD [(0.64 ± 0.27) mg / L ] Were significantly different from those before treatment [(23.60 ± 4.90), (49.10 ± 6.36) s, (93.10 ± 36.88) × 109 / L, (0.98 ± 0.25) mg / L] ) In the observation group [(14.70 ± 4.12), (36.96 ± 4.11) s, (166.60 ± 37.02) × 109 / L, (0.59 ± 0.26) mg / L] compared with those before treatment [(22.59 ± 5.21), (51.48 ± 5.97) s, (97.45 ± 43.01) × 109 / L, (0.99 ± 0.23) mg / L], all of which were statistically significant (all P <0.05). On the 12th day after treatment, PT [(16.89 ± 4.21) s], APTT (36.00 ± 4.52) s, Plt [(159.80 ± 33.69) × 109 / L] and DD [(0.55 ± 0.27) mg / L ] Were significantly higher than those before treatment (all P <0.05). The levels of [(13.60 ± 3.90), (30.55 ± 4.38) s, (160.50 ± 29.22) × 109 / L and (0.42 ± 0.21) mg / L] compared with before treatment, the differences were statistically significant (P <0.05). On the 8th and 12th days after treatment, the improvement of PT, APTT and D-D in the observation group were better than those in the control group. There was significant difference between the two groups (all P <0.05). Conclusion Xuebijing injection can improve coagulation disorders in patients with severe sepsis, which is beneficial to the treatment.