【摘要】 目的 探讨连续性血液净化联合乌司他丁治疗重症脓毒血症的临床疗效及对患者D-二聚体、降钙素原的影响。方法 回顾性纳入河南科技大学第一附属医院2021年1月至2022年12月收治的重症脓毒血症患者56例。根据治疗方案不同，分为血液净化组和血液净化联合乌司他丁组。比较两组患者治疗总有效率、总住院时间、抗生素持续使用时间、治疗7 d后APACHEⅡ评分和30 d生存率，以及治疗前后D-二聚体水平、降钙素原水平。结果 治疗7 d后，血液净化联合乌司他丁组患者治疗总有效率(92.86%)显著高于血液净化组(71.43%)(P<0.05)。血液净化联合乌司他丁组患者总住院时间、抗生素使用时间、治疗7 d后APACHEⅡ评分均显著低于血液净化组，30 d生存率显著高于血液净化组(P<0.05)。治疗7 d后，血液净化联合乌司他丁组患者D-二聚体水平和降钙素原水平均显著低于血液净化组(P<0.05)。结论 连续性血液净化联合乌司他丁治疗重症脓毒血症具有较高的临床疗效，可以显著减少患者总住院时间、抗生素使用时间、治疗7 d后APACHEⅡ评分，降低患者体内D-二聚体水平和降钙素原水平，提高患者30 d生存率，值得在临床重症脓毒血症治疗中推广。更多还原

【Abstract】 Objective To explore the clinical efficacy of continuous blood purification combined with ulinastatin in the treatment of severe sepsis and its influence on D-dimer and procalcitonin. Methods Totally 56 patients with severe sepsis admitted to the First Affiliated Hospital of Henan University of Science and Technology from Jan. 2021 to Dec. 2022 were included retrospectively. According to different treatment schemes, they were divided into blood purification group and blood purification combined with ulinastatin group. The total effective rate, total hospital stay, antibiotic duration, APACHEⅡ score after 7 days of treatment, 30-day survival rate, D-dimer level and procalcitonin level before and after treatment were compared between the two groups. Results After 7 days of treatment, the total effective rate(92.86%) of blood purification combined with ulinastatin group was significantly higher than that of blood purification group(71.43%)(P<0.05). The total hospital stay, antibiotic duration, APACHEⅡscore after 7 days of treatment in the blood purification combined with ulinastatin group were significantly lower than those of the blood purification group, and the 30-day survival rate was significantly higher than that of the blood purification group(P<0.05). After 7 days of treatment, the levels of D-dimer and procalcitonin in blood purification combined with ulinastatin group were significantly lower than those of blood purification group(P<0.05). Conclusion Continuous blood purification combined with ulinastatin has high clinical efficacy in the treatment of severe sepsis, which can significantly reduce the total hospitalization time, antibiotic use time, APACHEⅡscore after 7 days of treatment, reduce the levels of D-dimer and procalcitonin, and improve the 30-day survival rate. It is worthy of popularization and application in clinical treatment of severe sepsis.更多还原