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目的探讨血必净联合乌司他丁对脓毒血症合并感染性休克患者血流动力学及生存质量的影响。方法选取2014年10月—2016年11月收治的脓毒血症合并感染性休克患者79例,随机分为对照组39例、观察组40例。对照组静脉滴注乌司他丁20万U+250 ml氯化钠溶液,每间隔8 h静脉给药1次。观察组在以上基础上静脉滴注血必净50ml,每间隔12 h给药1次。两组均治疗2周。治疗前及治疗2周比较两组血流动力学各指标[HR、中心静脉压(central venous pressure,CVP)、平均动脉压(mean arterial pressure,MAP)、心脏指数(confidential Information,CI)]变化;采用生存质量量表(The WHO quality of lfe,WHOQOL)评估比较两组治疗前后生存质量。计量资料比较采用t检验,P<0.05为差异有统计学意义。结果治疗后观察组HR[(88.06±10.74)次/min]低于对照组[(93.27±10.73)次/min],CVP、CI及MAP[(8.77±2.23)cm H_2O、(4.56±1.09)L·min~(-1)·m~(-2)、(74.88±10.72)mm Hg]均高于对照组[(7.27±3.03)cm H_2O、(3.61±0.93)L·min~(-1)·m~(-2)、(70.18±6.62)mm Hg],比较差异有统计学意义(均P<0.05)。治疗后观察组生存质量评分[(400.34±39.57)分]高于对照组[(321.40±69.16)分],比较差异有统计学意义(P<0.05)。结论乌司他丁与血必净联合治疗可改善脓毒血症合并感染性休克患者血流动力学,提高生存质量。
Objective To investigate the effect of Xuebijing combined with ulinastatin on hemodynamics and quality of life in patients with sepsis complicated by septic shock. Methods Seventy-nine patients with septic shock and septic shock admitted from October 2014 to November 2016 were randomly divided into control group (n = 39) and observation group (n = 40). Control group intravenous infusion of Ulinastatin 200 000 U + 250 ml of sodium chloride solution, intravenously every 8 h once. The observation group on the basis of the above intravenous drip Xuebijing 50ml, administered once every 12 h. Both groups were treated for 2 weeks. The changes of hemodynamics [HR, central venous pressure (CVP), mean arterial pressure (MAP) and confidential information (CI)] in both groups before and 2 weeks after treatment were compared ; The Quality of Life Scale (WHOQOL) was used to evaluate the quality of life of the two groups before and after treatment. Measurement data were compared using t test, P <0.05 for the difference was statistically significant. Results After treatment, the HR of the observation group (88.06 ± 10.74) times / min was lower than that of the control group (93.27 ± 10.73) / min, CVP, CI and MAP [(8.77 ± 2.23) cm H_2O and (4.56 ± 1.09) L · min ~ (-1) · m -2, (74.88 ± 10.72) mm Hg] were higher than those in the control group [(7.27 ± 3.03) cm H 2 O, (3.61 ± 0.93) L · min -1 ) · M ~ (-2), (70.18 ± 6.62) mm Hg], the difference was statistically significant (P <0.05). After treatment, the quality of life score of the observation group [(400.34 ± 39.57) points] was higher than that of the control group [(321.40 ± 69.16) points), with significant difference (P <0.05). Conclusion The combination of ulinastatin and Xuebijing can improve the hemodynamics and improve the quality of life in patients with sepsis and septic shock.