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目的:观察纳洛酮联合血必净治疗感染性休克的临床疗效,并探讨其可能的作用机制。方法:对45例感染性休克患者,随机分为2组,治疗组23例,对照组22例,治疗组患者在常规抗休克治疗的基础上加用纳洛酮联合血必净治疗。结果:治疗组总有效率为91.3%,明显好于对照组72.7%(P<0.05),监测血液动力学变化△CVP、△MAP、△UA、△ScvO2治疗组明显好于对照组(P<0.05)。治疗组MODS的发生率为30.4%(7/23)。病死率为13.0%(3/23),对照组MODS的发生率为54.6%(12/22),病死率为27.3%(6/22),两组MODS的发生率比较差异有统计学意义(P<0.05)。结论:纳洛酮联合血必净能够显著改善感染性休克患者的病情,提高生存率。作用机制可能与纳洛酮能拮抗β内啡肽,血必净能降低内毒素的水平有关。
Objective: To observe the clinical efficacy of naloxone combined with Xuebijing in the treatment of septic shock and to explore its possible mechanism. Methods: Forty-five patients with septic shock were randomly divided into two groups: 23 in the treatment group and 22 in the control group. The patients in the treatment group were treated with naloxone and Xuebijing in addition to the conventional anti-shock treatment. Results: The total effective rate in the treatment group was 91.3%, which was significantly better than that in the control group (72.7%, P <0.05). The hemodynamic changes in CVP, △ MAP, △ UA and △ ScvO2 groups were significantly better than those in the control group (P < 0.05). The incidence of MODS in the treatment group was 30.4% (7/23). The mortality was 13.0% (3/23). The incidence of MODS in control group was 54.6% (12/22) and the mortality rate was 27.3% (6/22). There was significant difference in the incidence of MODS between the two groups P <0.05). Conclusion: Naloxone combined with Xuebijing can significantly improve the condition of patients with septic shock and improve the survival rate. Mechanism of action may be antagonized by naloxone β-endorphin, Xuebijing can reduce the level of endotoxin.