本文選題：血必凈注射液 + 膿毒癥�。� 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的:評估膿毒癥患者在常規(guī)治療基礎(chǔ)上加用血必凈注射液治療后,患者凝血四項(xiàng)以及血小板計數(shù)和血小板功能的變化以及對預(yù)后的影響。方法:將2016年4月至2017年4月入住廣西醫(yī)科大學(xué)第一附屬醫(yī)院重癥醫(yī)學(xué)科二病區(qū)的42例膿毒癥患者隨機(jī)分為血必凈治療組(n=21)(以下簡稱治療組)和對照組(n=21)。兩組患者均給予常規(guī)強(qiáng)有力的抗感染以及器官功能支持,治療組加用血必凈注射液50ml靜脈泵入,每日兩次,用藥一周。對照組注射等量等療程的生理鹽水,觀察兩組用藥前、用藥后第7天血小板計數(shù)、凝血四項(xiàng)變化,血栓彈力圖檢測的結(jié)果差異,并進(jìn)行統(tǒng)計分析。結(jié)果:(1)治療前和治療后第7天組內(nèi)比較,血栓彈力圖指標(biāo)兩組均有α角、MA增加,R縮短(P0.05),K無顯著變化。凝血四項(xiàng)指標(biāo)兩組均有PT、APTT縮短,PLT計數(shù)增加。對照組FIB治療后下降。兩組APACHE-II評分均有降低。(P0.05)(2)治療第7天后組間比較血栓彈力圖指標(biāo)治療組較對照組R值縮短,MA值增加,α增大(P0.05),兩組K值比較無意義。凝血四項(xiàng)指標(biāo)治療組APTT比對照組縮短明顯,治療組血小板計數(shù)比對照組增加顯著。差異有統(tǒng)計學(xué)意(P0.05),FIB在兩組間比較無顯著差異。APCHII評分治療組較對照組降低(P0.05);(3)兩組患者28天生存率比較,治療組死亡9例,死亡率為42.9%,對照組死亡11例,死亡率52.4%,兩組死亡率比較差異無統(tǒng)計學(xué)意義。結(jié)論:常規(guī)標(biāo)準(zhǔn)治療基礎(chǔ)上加用血必凈注射液能夠改善膿毒癥患者的凝血功能,改善短期APACH-II評分,但對患者最終預(yù)后無明顯改善作用。
[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 偽 -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 偽 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.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R459.7

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