血必净注射液联合床旁高流量持续血液净化治疗重症脓毒症患者的临床疗效分析

摘要:目的 探讨血必净注射液（XBJ）联合床旁高流量持续血液净化（CBP）治疗重症脓毒症患者的临床疗效。方法 选择本医院自2013年12月至2015年12月接诊的重症脓毒症患者48例，将其中仅接受XBJ注射的24例患者作为对照组，将同时接受XBJ注射和床旁高流量CBP治疗的另外24例作为观察组。分别于治疗前和治疗后观察并记录患者的APACHE II评分，WBC、CRP、PCT、血浆中细胞因子IL-8、Ang-2和MMP-9的水平。结果 观察组和对照组在治疗后24 h、72 h和7 d的中医证候积分和APACHE II评分较治疗前逐渐降低，且治疗结束即第7 d的评分显著低于治疗前，差异具有统计学意义（P＜0.05）。观察组和对照组在治疗后WBC、PCT以及CRP水平均低于治疗前，而观察组治疗后WBC、PCT以及CRP水平低于对照组，差异具有统计学意义（P＜0.05）。而观察组在治疗后的中医证候积分和APACHE II评分低于对照组，且差异具有统计学意义（P＜0.05）。观察组患者治疗后血浆中细胞因子IL-8、Ang-2和MMP-9的水平较治疗前逐渐降低，观察组的细胞因子水平在治疗后也均低于对照组，且差异具有统计学意义（P＜0.05）。结论 XBJ注射液与床旁高流量CBP联合治疗重症脓毒症疗效，能够改善临床症状，降低病死率，值得临床推广。

Explore the effectiveness of the combination of xuebijing injection and bedside high flow continuous blood purification in the treatment of patients with severe sepsis

ObjectiveTo observe and explore the effectiveness of the combination of xuebijing injection (XBJ) and bedside high flow continuous blood purification (CBP) in the treatment of patients with severe sepsis. Methods 48 patients with SS in the hospital from June 2013 to June 2015 were selected, 24 patients which received only XBJ injection were the control group, another 24 cases also accepted XBJ injection and high flow CBP treatment were the observation group. The syndromes scores and APACHE II scores were observed and recorded before and after the treatment, as well as IL-8, Ang-2 and MMP-9 levels of plasma cytokines. Results The observation group and the control group, 24 h, 72 h and 7 d of TCM syndrome score and APACHE II score decreased compared to before treatment, and the 7 d scores were significantly lower than treatment. After the treatment, the TCM symptom score and APACHE II score of the observation group were lower than the control group, the difference was statistically significant (P <0.05). The level of plasma cytokine IL-8, Ang-2 and MMP-9 of the observation group and the control group were gradually reduced, Cytokine levels of the observation group were also lower than the control group, the difference was statistically significant (P <0.05). Conclusion The combination of xuebijing injection and bedside high flow continuous blood purification in the treatment of patients with severe sepsis have a good effect, can improve clinical symptoms and reduce mortality, and ultimately achieve the desired height.