血必净注射液对脓毒症患者凝血功能的影响

发布时间：2018-04-14 13:25

本文选题：血必净注射液 + 脓毒症　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的:评估脓毒症患者在常规治疗基础上加用血必净注射液治疗后,患者凝血四项以及血小板计数和血小板功能的变化以及对预后的影响。方法:将2016年4月至2017年4月入住广西医科大学第一附属医院重症医学科二病区的42例脓毒症患者随机分为血必净治疗组(n=21)(以下简称治疗组)和对照组(n=21)。两组患者均给予常规强有力的抗感染以及器官功能支持,治疗组加用血必净注射液50ml静脉泵入,每日两次,用药一周。对照组注射等量等疗程的生理盐水,观察两组用药前、用药后第7天血小板计数、凝血四项变化,血栓弹力图检测的结果差异,并进行统计分析。结果:(1)治疗前和治疗后第7天组内比较,血栓弹力图指标两组均有α角、MA增加,R缩短(P0.05),K无显著变化。凝血四项指标两组均有PT、APTT缩短,PLT计数增加。对照组FIB治疗后下降。两组APACHE-II评分均有降低。(P0.05)(2)治疗第7天后组间比较血栓弹力图指标治疗组较对照组R值缩短,MA值增加,α增大(P0.05),两组K值比较无意义。凝血四项指标治疗组APTT比对照组缩短明显,治疗组血小板计数比对照组增加显著。差异有统计学意(P0.05),FIB在两组间比较无显著差异。APCHII评分治疗组较对照组降低(P0.05);(3)两组患者28天生存率比较,治疗组死亡9例,死亡率为42.9%,对照组死亡11例,死亡率52.4%,两组死亡率比较差异无统计学意义。结论:常规标准治疗基础上加用血必净注射液能够改善脓毒症患者的凝血功能,改善短期APACH-II评分,但对患者最终预后无明显改善作用。
[Abstract]:Objective: to evaluate the changes of platelet count, platelet function and prognosis in patients with sepsis after treatment with Xuebijing injection.Methods: from April 2016 to April 2017, 42 patients with sepsis were randomly divided into two groups: Xuebijing treatment group (treatment group) and control group (control group).Patients in both groups were given routine and powerful anti-infection and organ function support. In the treatment group, Xuebijing injection 50ml was injected intravenously twice a day for one week.The control group was injected with saline of the same course of treatment. The platelet count, four changes of coagulation and the results of thromboelastography were observed and analyzed statistically in the two groups before and 7 days after treatment.Results before and after treatment, there was no significant change in 伪 -carrageenan in both groups before and on the 7th day after treatment, and there was no significant difference between the two groups.PTT APTT shortened PLT count was increased in both groups.In control group, FIB decreased after treatment.The APACHE-II score of both groups was lower than that of the control group 7 days after treatment, compared with that of the control group, the R value of the treatment group was shorter than that of the control group, and the value of MA was increased, the value of 伪 was increased (P 0.05), and the K value of the two groups was not significant.The APTT of the treatment group was shorter than that of the control group, and the platelet count of the treatment group was significantly higher than that of the control group.There was no significant difference in FIB between the two groups. The APCHII score in the treatment group was lower than that in the control group. (2) the 28-day survival rate in the treatment group was lower than that in the control group (9 cases died in the treatment group, the mortality rate was 42.9%, and 11 cases in the control group.There was no significant difference in mortality between the two groups.Conclusion: on the basis of routine standard therapy, Xuebijing injection can improve coagulation function and short-term APACH-II score in patients with sepsis, but it has no effect on the final prognosis of sepsis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R459.7

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