中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2015年
23期
84-87
,共4页
复合免疫%多发伤%脓毒症%卡文%尤文
複閤免疫%多髮傷%膿毒癥%卡文%尤文
복합면역%다발상%농독증%잡문%우문
Immunonutrition%Severe multiple injuries%Sepsis%Kabiven%Omegaven
目的：探讨严重多发伤合并脓毒症患者围手术期使用卡文联尤文行复合免疫治疗的疗效。方法纳入该院急重症医学科于2012年1月—2013年1月收治严重多发伤合并脓毒症的患者，共得到64例符合要求的患者，将其随机均分为对照组(n=32)及实验组(n=32)。观察所有患者治疗前及治疗一周时简化急性生理学评分Ⅱ、慢性健康状况评价Ⅱ、总蛋白、白蛋白、促红细胞生成素、超敏C反应蛋白、肿瘤坏死因子-α、白介素6、降钙素原、CD4+、CD8+及CD4+/CD8+比值的差异。结果通过一周的对比治疗，实验组的简化急性生理学评分Ⅱ显著降低、慢性健康状况评价Ⅱ显著降低，差异有统计学意义(P<0.05)，说明身体机能得到显著恢复；超敏C反应蛋白显著降低、肿瘤坏死因子-α显著降低、CD4+显著增加、CD8+显著增加、CD4+/CD8+比值显著增加，差异有统计学意义(P<0.05)，说明机体免疫功能得到改善。结论对于严重多发伤合并脓毒症患者围手术期予以复合免疫治疗，有助于维持免疫动态平衡，促使机体恢复促炎和抗炎平衡，改善预后。
目的：探討嚴重多髮傷閤併膿毒癥患者圍手術期使用卡文聯尤文行複閤免疫治療的療效。方法納入該院急重癥醫學科于2012年1月—2013年1月收治嚴重多髮傷閤併膿毒癥的患者，共得到64例符閤要求的患者，將其隨機均分為對照組(n=32)及實驗組(n=32)。觀察所有患者治療前及治療一週時簡化急性生理學評分Ⅱ、慢性健康狀況評價Ⅱ、總蛋白、白蛋白、促紅細胞生成素、超敏C反應蛋白、腫瘤壞死因子-α、白介素6、降鈣素原、CD4+、CD8+及CD4+/CD8+比值的差異。結果通過一週的對比治療，實驗組的簡化急性生理學評分Ⅱ顯著降低、慢性健康狀況評價Ⅱ顯著降低，差異有統計學意義(P<0.05)，說明身體機能得到顯著恢複；超敏C反應蛋白顯著降低、腫瘤壞死因子-α顯著降低、CD4+顯著增加、CD8+顯著增加、CD4+/CD8+比值顯著增加，差異有統計學意義(P<0.05)，說明機體免疫功能得到改善。結論對于嚴重多髮傷閤併膿毒癥患者圍手術期予以複閤免疫治療，有助于維持免疫動態平衡，促使機體恢複促炎和抗炎平衡，改善預後。
목적：탐토엄중다발상합병농독증환자위수술기사용잡문련우문행복합면역치료적료효。방법납입해원급중증의학과우2012년1월—2013년1월수치엄중다발상합병농독증적환자，공득도64례부합요구적환자，장기수궤균분위대조조(n=32)급실험조(n=32)。관찰소유환자치료전급치료일주시간화급성생이학평분Ⅱ、만성건강상황평개Ⅱ、총단백、백단백、촉홍세포생성소、초민C반응단백、종류배사인자-α、백개소6、강개소원、CD4+、CD8+급CD4+/CD8+비치적차이。결과통과일주적대비치료，실험조적간화급성생이학평분Ⅱ현저강저、만성건강상황평개Ⅱ현저강저，차이유통계학의의(P<0.05)，설명신체궤능득도현저회복；초민C반응단백현저강저、종류배사인자-α현저강저、CD4+현저증가、CD8+현저증가、CD4+/CD8+비치현저증가，차이유통계학의의(P<0.05)，설명궤체면역공능득도개선。결론대우엄중다발상합병농독증환자위수술기여이복합면역치료，유조우유지면역동태평형，촉사궤체회복촉염화항염평형，개선예후。
Objective To observe the efficacy of perioperative complex immunotherapy of Kabiven and Omegaven for patients with severe multiple injuries complicated with sepsis. Methods 64 patients with severe multiple injuries complicated with sepsis admit-ted to the ICU of our hospital who met the criteria were randomized into control group (n=32) and experimental group (n=32). The simplified acute physiology score II (SAPS II), chronic health evaluationⅡ(CHEⅡ), total protein (TP), albumin (ALB), erythropoi-etin (EPO), high sensitive C-reactive protein (hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), procalcitionin (PCT), CD4+, CD8+and CD4+/CD8+ratio before and 1 week after treatment were observed and compared between the two groups. Results After one week treatment, SAPS II and CHE Ⅱdecreased significantly and showed statistical differences with those before treat-ment(P<0.05), which meant that their physical functions were improved significantly; TNF-α, IL-6, CD4+, CD8+and CD4+/CD8+ratio increased significantly and showed statistical differences with those before treatment (P<0.05), which meant that their immune functions were improved significantly. Conclusion For patients with severe multiple injuries complicated with sepsis, perioperative complex immunotherapy of Kabiven and Omegaven can contribute to the maintaining of dynamic balance of immune function, pro-mote the restoration of pro/Anti-inflammatory balance, and improve prognosis.
