目的 探究血必凈注射液聯(lián)合亞胺培南治療肝硬化并發(fā)自發(fā)性細(xì)菌性腹膜炎的臨床療效。方法 選取2013年8月—2015年8月黃河三門峽醫(yī)院消化內(nèi)科收治的肝硬化并發(fā)自發(fā)性細(xì)菌性腹膜炎患者88例,隨機(jī)分為對(duì)照組和治療組,每組各44例。對(duì)照組患者腹腔穿刺放液≤2 000 mL/d,放液后給予注射用亞胺培南西司他丁鈉0.5 g/次,1次/d,同時(shí)靜脈滴注注射用亞胺培南西司他丁鈉,0.5 g加入到0.9%生理鹽水100 mL中,3次/d。治療組在對(duì)照組治療基礎(chǔ)上靜脈滴注血必凈注射液,50 mL加入到0.9%生理鹽水100 mL中,1次/d。兩組均連續(xù)治療7 d。觀察兩組的臨床療效,比較兩組發(fā)熱、腹脹、腹痛、腹部壓痛和反跳痛等臨床癥狀消失時(shí)間。觀察兩組并發(fā)癥的發(fā)生率,同時(shí)比較兩組治療前后白細(xì)胞(WBC)、C反應(yīng)蛋白(CRP)、降鈣素原(PCT)、腫瘤壞死因子α(TNF-α)、白細(xì)胞介素6(IL-6)的變化。結(jié)果 治療后,對(duì)照組和治療組的總有效率分別為75.00%、90.91%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療組發(fā)熱、腹脹、腹痛、腹部壓痛和反跳痛等臨床癥狀消失時(shí)間均顯著短于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組WBC、CRP、PCT、TNF-α、IL-6均較治療前顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療7 d后治療組這些觀察指標(biāo)顯著低于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。對(duì)照組和治療并發(fā)癥的總發(fā)生率分別為18.18%、4.55%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 血必凈注射液聯(lián)合亞胺培南治療肝硬化并發(fā)自發(fā)性細(xì)菌性腹膜炎的臨床療效顯著,可以顯著緩解臨床癥狀,降低并發(fā)癥的發(fā)生率,還可以降低血清炎癥因子的表達(dá),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore clinical efficacy of Xuebijing Injection combined with imipenem in treatment of liver cirrhosis complicated with spontaneous bacterial peritonitis. Methods Patients (88 cases) with liver cirrhosis complicated with spontaneous bacterial peritonitis in Huanghe Sanmenxia Hospital from August 2013 to August 2015 were randomly divided into control and treatment groups, and each group had 44 cases. The patients in the control group were administered with abdominal puncture, and drainage was less than or equal to 2000 mL/d, and they were given Imipenem and Cilastatin Sodium for injection 0.5 g/time after liquid discharge, once daily. The patients in the control group were iv administered with Imipenem and Cilastatin Sodium for injection, 0.5 g added into 0.9% normal saline 100 mL, three times daily. The patients in the treatment group were iv administered with Xuebijing Injection, 50 mL added into 0.9% normal saline 100 mL, once daily. The patients in two groups were treated for 7 d. After treatment, the efficacy was evaluated, and disappeared time of clinical symptoms such as fever, abdominal distension, abdominal pain, abdominal tenderness, and back pain in two groups were compared. The incidence of complications in two groups was observed, and the changes of WBC, CRP, PCT, TNF-α, and IL-6 in two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 75.00% and 90.91%, respectively, and there were differences between two groups (P < 0.05). Disappeared times of clinical symptoms such as fever, abdominal distension, abdominal pain, abdominal tenderness and back pain in two groups were shorter than those in control group, with significant difference between two groups (P < 0.05). WBC, CRP, PCT, TNF-α, and IL-6 were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). After treatment for 7 d, the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). The incidence of complications in the control and the treatment groups were 18.18% and 4.55%, with significant difference between two groups (P < 0.05). Conclusion Xuebijing Injection combined with imipenem has clinical curative effect in treatment of liver cirrhosis complicated with spontaneous bacterial peritonitis, and can significantly relieve the clinical symptoms, also can reduce the incidence of complications, while can reduce the expression of serum inflammatory cytokines, which has a certain clinical application value.