血必净联合抗凝治疗急性呼吸窘迫综合征的临床观察

目的研究血必净联合抗凝治疗急性呼吸窘迫综合征(ARDS)的临床疗效。方法选取我院2013年11月至2015年11月ARDS患者86例,随机分为观察组与对照组两组,每组43例,给予对照组患者抗凝治疗,观察组在对照组治疗基础上联合血必净治疗,比较两组患者治疗前后气道峰压(PAP)、氧合指数(PaO_2/FiO_2)水平变化,肿瘤坏死因子α(TNF-α)、C反应蛋白(CRP)、白介素6(IL-6)、白介素8(IL-8)等炎性因子水平变化以及凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)、纤维蛋白原(Fbg)、血小板计数(PLT)等指标变化,比较两组患者机械通气时间、ICU住院时间及死亡率。结果治疗后观察组PAP水平较对照组显著较低,PaO_2/FiO_2水平较对照组显著较高(P0.05);观察组TNF-α、CRP、IL-6、IL-8等炎性因子水平较对照组显著降低(P0.05);观察组患者机械通气时间和ICU平均住院时间较对照组显著较短(P0.05);观察组患者死亡率为16.28%较对照组34.88%显著较低(P0.05)。结论血必净联合抗凝治疗ARDS临床疗效显著,患者的炎性因子水平显著降低,凝血功能得到改善,肺通气功能提高,死亡率降低。

Clinical Observation on Xuebijing Injection Combined with Anticoagulant Therapy for Treating Acute Respiratory Distress Syndrome

Objective To study the clinical effect of Xuebijing injection combined with anticoagulant therapy in treating acute respiratory distress syndrome (ARDS).Methods 86 patients with ARDS admitted in our hospital between November 2013 and November 2015 were randomized into observation group and control group,43 cases in each group.The control group received anticoagulant therapy,while the observation group,based on the treatment in the control group,was treated with Xuebijing injection.Changes of the peak airway pressure (PAP),oxygenation index (PaO2/FiO2) levels,tumor necrosis factor α (TNF-α),C reactive protein (CRP),interleukin 6 (IL-6),interleukin 8 (IL-8) and other inflammatory factors,prothrombin time (PT),activated partial thromboplastin time (aPTT),fibrinogen (Fbg),platelet count (PLT) before after treatment were compared between the two groups.The duration of mechanical ventilation,length of stay in ICU and mortality rate were also compared.Results After treatment,PAP level in the observation group was significantly lower than that in the control group while the PaO2/FiO2 level was significantly higher (P ＜ 0.05);The levels of TNF-α,CRP,IL-6 and IL-8 in the observation group were significantly lower than those in the control group (P ＜ 0.05),The duration of mechanical ventilation and length of stay in ICU of the observation group was significantly shorter than that of control group (P ＜ 0.05).The mortality rate in the observation group (16.28％) was significantly lower than that in control group (34.88％) (P ＜ 0.05).Conclusion The clinical effect of Xuebijing injection combined with anticoagulant therapy in the treatment pf patients with ARDS is significant.It can significantly reduce the levels of inflammatory factors,improve blood coagulation function and pulmonary ventilation function,and reduce mortality.