【摘要】 目的观察血必净注射液治疗对多发性创伤早期并发脓毒症、多器官功能障碍综合征(MODS)患者预后的影响。方法选择急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分>15分的多发性创伤患者60例,随机分为治疗组和对照组,每组30例。两组均按多发性创伤常规治疗;治疗组在常规治疗基础上于入院1 d起用血必净注射液80 ml静脉滴注,12 h 1次,连用7d。统计两组脓毒症和MODS的发生率以及28 d病死率;检测入院即刻、3、5和7 d APACHEⅡ评分及血清肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、IL-6、IL-10水平。结果入院3d起,治疗组APACHEⅡ评分和TNF-α、IL-1β、IL-6、IL-10水平均低于对照组,至5d时下降更明显,两组比较差异有统计学意义(P均<0.05)。治疗组脓毒症发生率为43.3%(13/30),MODS发生率为23.3%(7/30),病死率为13.3%(4/30);对照组脓毒症发生率为63.3%(19/30),MODS发生率为53.3%(16/30),病死率为40.0%(12/30),两组比较差异均有统计学意义(P均<0.05)。结论多发性创伤早期应用血必净注射液能减轻病情严重程度,显著降低脓毒症、MODS的发生率,从而改善多发性创伤患者的预后。更多还原

【Abstract】 Objective To observe the effect of early Xuebijing injection(血必净注射液)treatment on the change of prognosis in patients with multiple traumas complicated with sepsis and multiple organ dysfunction syndrome(MODS).Methods All of 60 cases with multiple traumas as well as acute physiology and chronic health evaluation(APACHEⅡ)>15 scores were randomly divided into therapeutic group (30 cases)and control group(30 cases).The two groups were treated with the same conventional therapy. From the 1st day of admission,Xuebijing injection 80 ml was given by intravenous drip once for every 12 hours for 7 days to the therapeutic group.The level of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),IL-6,IL-10,and APACHEⅡscore were tested on 1,3,5 and 7 days after admission.The case fatality and incidences rates of sepsis and MODS in both groups were recorded.Results Compared with the control group,APACHEⅡscore,TNF-α,IL-1β,IL-6 and IL-10 of the therapeutic group were lower significantly on the 3rd day after admission,especially on the 5th day(all P<0.05)in the therapeatic group. The incidences of sepsis,MODS,and the rate of case fatality of MODS were 43.3%(13/30),23.3%(7/30) and 13.30%(4/30),respectively in the therapeutic group,the percentages being lower than those 63.3% (19/30),53.3%(16/30)and 40.0%(12/30),respectively in the control group(all P<0.05).Conclusion Early Xuebijing injection treatment in multiple traumas can reduce the disease severity,and decrease the incidences of sepsis and MODS significantly,thereby it may improve the prognosis of patients with multiple traumas.更多还原