Clinical Study of Continuous Blood Purification Combined with Ulinastatin in Treatment of Septic Shock
LI Bing,LU Hong-jun,CUI Nai-qiang
Traditional Chinese Medicine Hospital of Rizhao, Shandong Province, Rizhao (276800), China
Abstract:
Objective To investigate the clinical effect of continuous blood puri.cation (CBP) combined with ulinastain in the treatment of sepsis shock. Methods Totally 120 patients diagnosed as severe sepsis were randomly divided into control group and observation group. Both groups were given routine anti-infection, .uid resuscitation, puncture and drainage to control the infection focus, dopamine, norepinephrine and other vasoactive drugs, even mechanical ventilation when necessary. At the same time, both groups were treated with CBP within 4 hours when diagnosed as severe sepsis. On this basis, the observation group received intravenous ulinastatin 500000/d for 7 days. The levels of plasma C-reactive protein (CRP), serum lactic acid (Lac), procalcitonin (PCT) and interleukin-10 (IL-10) were measured at admission and on the 1st, 3rd and 5th days after admission. Sequential organ failure assessment (SOFA) and acute physiology and chronic health score II (APACHE II) were performed at admission and on the 1st, 3rd and 5th days after admission. Results CRP, Lac, PCT and IL-10 were lower in the two groups at each time point after treatment than before treatment (all P<0.05), and Lac, PCT and IL-10 in the observation group were significantly lower than those in the control group at each time point after admission. The SOFA score and APACHEII score of the two groups were significantly lower than those of the control group on the 1st, 3rd, 5th day after admission (all P<0.05), and the SOFA score and APACHEII score of the observation group on the 1st, 3rd, 5th day after admission were signi.cantly lower than those of the control group at the same time point (all P<0.05). Conclusions CBP combined with ulinastatin can remove inflammatory mediators, correct ischemia and hypoxia, improve hypoperfusion of tissues, cells and organs, maintain hemodynamic stability and reduce organ damage, which is worthy of early application in severe sepsis patients.
