论文部分内容阅读
目的研究血必净联合抗生素治疗肝硬化继发肺部感染的临床疗效,为肝硬化继发肺部感染的临床治疗提供依据。方法选取2014年1月至2015年12月在衢州市人民医院感染科住院治疗的120例肝硬化合并肺部感染患者作为研究对象,随机分为血必净组及对照组。两组患者均采用头孢吡肟(100 ml生理盐水+2 g头孢吡肟)抗感染治疗,血必净组在此基础上加用血必净注射液(100 ml生理盐水+100 ml血必净注射液,2次/d),两组疗程均为14 d。比较两组患者治疗前后临床症状消失时间、肝功能、白细胞介素-2(IL-2)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)的变化情况,比较两组患者总有效率及并发症的发生情况。采用SPSS 17.0统计软件包进行t检验、χ~2检验和Wilcoxon秩和检验。结果治疗后,血必净组患者发热、腹胀、腹痛、腹部压痛及反跳痛等临床症状消失时间显著短于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者血清降钙素原(PCT)、IL-2、IL-6、TNF-α、丙氨酸转氨酶(ALT)及总胆红素(TBIL)均较治疗前下降,且血必净组下降幅度更大,差异均有统计学意义(P<0.05,P<0.01);而凝血酶原活动度(PTA)较治疗前显著上升,且血必净组上升幅度更大,差异均有统计学意义(P<0.05,P<0.01)。血必净组治疗总有效率为88.3%,显著高于对照组(73.33%),差异有统计学意义(χ~2=5.25,P<0.05)。血必净组总并发症的发生率为11.67%,显著低于对照组(23.33%),差异有统计学意义(χ~2=4.36,P<0.05)。结论血必净联合抗生素治疗肝硬化继发肺部感染临床疗效显著,不仅可以缩短临床症状的持续时间,而且可有效清除血清类毒素,减少炎症因子的表达,值得临床进一步研究及推广。
Objective To study the clinical efficacy of Xuebijing combined with antibiotics in the treatment of secondary pulmonary infection of cirrhosis and provide the basis for the clinical treatment of secondary pulmonary infection of cirrhosis. Methods From January 2014 to December 2015, 120 patients with cirrhosis and pulmonary infection in inpatient department of Quzhou People’s Hospital were randomly divided into Xuebijing group and control group. Two groups of patients were treated with cefepime (100 ml saline +2 g cefepime) anti-infection treatment, Xuebijing group on this basis with Xuebijing injection (100 ml of saline +100 ml of blood will net Injection, 2 times / d), two courses of treatment were 14 d. The changes of clinical symptom disappearance time, liver function, interleukin-2, interleukin-6 and tumor necrosis factor-α (TNF-α) were compared between the two groups before and after treatment. The total effective rate and complications of the two groups were compared. SPSS 17.0 statistical package was used for t test, χ ~ 2 test and Wilcoxon rank sum test. Results After treatment, the disappearance time of clinical symptoms such as fever, bloating, abdominal pain, abdominal tenderness and rebound tenderness in Xuebijing group was significantly shorter than that in control group (P <0.05). After treatment, serum procalcitonin (PCT), IL-2, IL-6, TNF-α, ALT and total bilirubin (TBIL) (P <0.05, P <0.01), while the prothrombin activity (PTA) increased significantly compared with that before treatment, and the increase in Xuebijing group was larger, the difference was statistically significant All were statistically significant (P <0.05, P <0.01). The total effective rate of Xuebijing group was 88.3%, which was significantly higher than that of the control group (73.33%), the difference was statistically significant (χ ~ 2 = 5.25, P <0.05). The incidence of total complication in Xuebijing group was 11.67%, which was significantly lower than that in control group (23.33%), the difference was statistically significant (χ ~ 2 = 4.36, P <0.05). Conclusion Xuebijing combined antibiotics treatment of cirrhosis secondary lung infection clinical significant effect, not only can shorten the duration of clinical symptoms, and can effectively remove the serum toxoid and reduce the expression of inflammatory cytokines, deserving clinical further research and promotion.