摘要
目的观察去甲肾上腺素联合血必净治疗脓毒症合并多器官功能障碍综合征(MODS)的疗效及其对乳酸代谢的影响。方法将本院收治的92例脓毒症合并MODS患者根据不同治疗方法均分为去甲肾上腺素组(去甲肾上腺素治疗)与血必净联合组(血必净联合去甲肾上腺素治疗)。比较两组患者血清炎症因子[白细胞介素-6(IL-6)、降钙素原(PCT)]水平、急性生理和慢性健康状况评价Ⅱ(APACHEⅡ)和脓毒症相关性器官功能衰竭评价(SOFA)评分、乳酸代谢情况以及预后情况。结果治疗后,两组IL-6、PCT、乳酸水平以及APACHEⅡ和SOFA评分均降低(P<0.05),且血必净联合组低于去甲肾上腺素组(P<0.05)。血必净联合组乳酸清除率高于去甲肾上腺素组(P<0.05)。血必净联合组重症医学病房(ICU)住院时间短于去甲肾上腺素组(P<0.05);但两组ICU病死率和28天病死率比较,差异无显著性(P>0.05)。结论去甲肾上腺素联合血必净可以有效减轻脓毒症合并MODS患者的炎症反应,改善患者的临床症状,提高乳酸清除率,缩短患者的ICU住院时间,促进患者的早期康复。
Aim To observe the efficacy of norepinephrine combined with Xuebijing in the treatment of sepsis complicated with multiple organ dysfunction syndrome(MODS)and its impact on lactate metabolism.Methods A total of 92 patients with sepsis complicated by MODS admitted to our hospital were equally divided into the norepinephrine group(treated with norepinephrine alone)and the Xuebijing combination group(treated with Xuebijing combined with norepinephrine)based on different treatment methods.The serum levels of inflammatory factors[interleukin-6(IL-6),procalcitonin(PCT)],acute physiology and chronic health evaluationⅡ(APACHEⅡ)scores,sepsis-related organ failure assessment(SOFA)scores,lactate metabolism and prognosis were compared between the two groups.Results After treatment,the levels of IL-6,PCT,lactate,as well as APACHEⅡand SOFA scores,were decreased in both groups(P<0.05),with the Xuebijing combination group showing lower values than the norepinephrine group(P<0.05).The lactate clearance rate was higher in the Xuebijing combination group than that in the norepinephrine group(P<0.05).The intensive care unit(ICU)length of stay was shorter in the Xuebijing combination group(P<0.05);however,there was no significant difference in ICU mortality or 28-day mortality between the two groups(P>0.05).Conclusion Norepinephrine combined with Xuebijing can effectively reduce the inflammatory response in patients with sepsis complicated by MODS,improve clinical symptoms,enhance lactate clearance,shorten ICU length of stay,and promote early recovery.
作者
孟聪峰
周明虎
李芝朋
许正峰
MENG Congfeng;ZHOU Minghu;LI Zhipeng;XU Zhengfeng(Department of Critical Care Medicine,Fuyang Women and Children's Hospital,the Sixth People's Hospital of Fuyang,Fuyang 236000,Anhui,China)
出处
《中南医学科学杂志》
2025年第4期735-738,共4页
Medical Science Journal of Central South China
基金
阜阳市卫生健康委科研项目(FY2021-155)。
作者简介
孟聪峰,主治医师,研究方向为重症医学类疾病的诊治,E-mail为18324865255@163.com;通信作者:许正峰,副主任医师,研究方向为重症医学类疾病的诊治,E-mail为2528410264@qq.com。
