摘要:ObjectiveTo observe the clinical effect of low dose heparin combined with Xuebijing in the treatment of sepsis.Method78 cases of sepsis patients in our hospital from April 2008 to April 2013 were chose as the subjects of study, and they were divided into observation group and control group according to the random number table method, 39 cases in each group. All patients were treated with conventional therapy, and received intravenous drip of Xuebijing. Observation group patients were treated with low dose of heparin on the basis of the above treatment. While the same dose of saline was added in control group. Coagulation parameters, inlfammatory factors, APACHEⅡscore, liver and kidney function changes, adverse reactions and prognosis between the two groups were compared.ResultAfter treatment, PLT, FIB levels were signiifcantly increased in the two groups (P<0.05), and D-D level signiifcantly decreased (P<0.05), with more signiifcant changes in observation group (P<0.05). After treatment, APTT, PT in observation group signiifcantly reduced (P<0.05), with no signiifcant change in control group (P>0.05). After treatment, IL-6, TNF-α levels and APACHEⅡ score were signiifcantly decreased in the two groups (P<0.05), observation group decreased more signiifcantly (P<0.05). IL-10 level in the two groups had no signiifcant changes before and after treatment (P>0.05). After treatment, ALT, AST, BUN, SCr levels signiifcantly decreased (P<0.05). SCr level decreased more signiifcantly in observation group (P<0.05). During the treatment, the two groups patients had no active bleeding, allergies and other adverse reactions. The mortality rate in observation group was signiifcantly lower than control group (P<0.05), the mean survival time was signiifcantly higher than control group (P<0.05).ConclusionLow dose heparin combined with Xuebijing injection can effectively improve the blood coagulation function and reduce inlfammatory level, with exact curative effect and safety, worthy of clinical promotion.%目的:观察小剂量肝素联合血必净治疗脓毒症的临床效果。方法选取本院2008年4月至2013年4月收治的78例脓毒症患者为研究对象,按照随机数表法将其分为观察组与对照组,每组各39例。两组患者均接受常规治疗,并静脉滴注血必净。观察组患者在此基础上加用小剂量肝素,对照组加用等剂量生理盐水。比较两组患者治疗前后凝血指标、炎性因子水平、急性生理功能和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、肝肾功能变化、不良反应发生情况及预后转归。结果两组患者治疗后血小板计数(PLT)、纤维蛋白原(FIB)水平较治疗前均显著上升(P<0.05),D-二聚体(D-D)水平均显著下降(P<0.05),观察组变化较对照组显著(P<0.05);治疗后观察组患者活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)较治疗前显著缩短(P<0.05),对照组未见明显变化(P>0.05)。两组患者治疗后白细胞介素(IL)-6、肿瘤坏死因子-α(TNF-α)水平及APACHEⅡ评分均显著降低(P<0.05),观察组降低更明显(P<0.05);两组患者治疗前后IL-10水平均未见明显变化(P>0.05)。两组患者治疗后谷丙转氨酶(ALT)、谷草转氨酶(AST)、血肌酐(SCr)、尿素氮(BUN)水平较治疗前均显著降低(P<0.05),观察组患者SCr水平降低较对照组更明显(P<0.05)。两组患者治疗期间均未见活动性出血、过敏等不良反应发生。观察组患者病死率显著低于对照组(P<0.05),平均生存时间显著长于对照组(P<0.05)。结论小剂量肝素联合血必净治疗脓毒症,可有效改善患者凝血功能,降低机体炎性水平,疗效确切,安全性好,值得临床推广应用。