Ulinastatin To Study The Curative Effect Of Patients With Severe Sepsis

Background: Sepsis is a systemic inflammatory response caused by the pathogenic bacteria(bacteria, viruses, fungi) into the bloodstream. Into the blood of the purulent bacteria in the blood of a large number of breeding and growth of the same time with the blood circulation to the body of other tissues and systems, and reproduction, growth, and eventually make the body in a malignant inflammatory reaction state. Severe sepsis associated with organ failure will enable organizations to pay attention to adverse and hypotension,due to the presence of patients with organ failure, with mortality is taller.Although medical technology in continuous progress, people against the graduate students also unceasingly thorough, however, in the ICU, due to death in sepsis patients in ICU deaths still occupies a large proportion. The treatment of sepsis and therefore subject to people’s attention, in conventional sepsis treatment is mainly in the use of antibiotics to improve in patients with systemic inflammatory state at the same time, to patients and other symptoms of symptomatic treatment, improve patients with organ failure, at the same time, strengthen the monitoring of patients, when necessary will be placed in the ICU give support respiratory and circulatory support. Even so, the number of patients died of sepsis each year is still relatively large, only in North America, nearly 500000 patients a year, due to the death of sepsis, there are about 200000. As early as October 2002, the Surviving(Sepsis CamPaign),which was launched by the American Association of critical care(SCCM), the European Association of critical care(ESCIM) and the International(ISF),was conducted in Barcelona. Under the background of international cooperation, a number of research results show that in sepsis pathological changes, cell factor plays a decisive role, under the stimulation of surgery,trauma, infection and so on, enhanced the stress reaction of the patients,proinflammatory cytokines, oxygen free radicals, protease water solution of enzymes and other inflammatory mediators release increased, further aggravating the tissue cells of the patients with injury and organ function failure, aggravate the symptoms in patients with sepsis.Ulinastatin is extracted from the urine of healthy individuals of broad-spectrum protease inhibitor, is the body of the endogenous anti inflammatory substances, inhibition of proteolytic activity at the same time also can regulate the release of inflammatory cytokines, and can inhibit the production of oxygen free radicals, clinically for acute and chronic pancreatitis caused by body reperfusion injury, has a role in protecting ischemic organ function. The existing animal experimental results demonstrated that Ulinastatin can reduce the risk of septic shock, and ulinastatin for clinical trials reported less, based on the theoretical basis of ulinastatin pharmacological effects of organic the sepsis animal time of the treatment of foundation, ulinastatin for treatment of patients with severe sepsis has certain feasibility.Objective:Study of ulinastatin he Ding of severe sepsis septic arthritis reactivity effects. Analysis treatment effect of ulinastatin in severe sepsis, to promote clinical rational, scientific and medical treatment.Methods:90 cases of severe sepsis patients in our hospital in January2014, January 2015, cases of severe sepsis. Selected patients need to comply with the criteria for severe sepsis in 2012 International Sepsis guidelines, the diagnosis of severe sepsis after establishment of the inclusion test time is no more than 6 hours. Age 18 years old-70 years, and except for acute myocardial infarction, malignant tumor, blood diseases, poisoning patients.CRRT treatment, can guide patients enrolled in a conventional anti sepsis patients randomly divided into 3 groups: routine treatment group(group A),that is, 2012 in accordance with septic shock treated with conventional fluid resuscitation, anti infection, to maintain a stable environment, the protection of organ function, the necessary given mechanical ventilation therapy;Ulinastatin treatment group(B group), in the conventional treatment based onintravenous infusion of ulinastatin, 10 million U, daily 3 times, for 5consecutive days; Ulinastatin high dose group(Group C), in the conventional treatment based on intravenous infusion of ulinastatin, 20 million U, daily 3times, for 5 consecutive days. APACHE II score, SOFA score, and serum Creactive protein were observed before and after treatment in the three groups,while the early blood lactate clearance rate and the mortality rate were compared between the three groups.Results:Three groups of patients before treatment APACHE II score,SOFA score, serum C- reactive protein differences were not statistically significant, with different treatment plan for treatment, including C group of patients with B, C two groups, and C group of patients with a long duration of4.23 days, B, A two groups of patients with longer duration of treatment, after28 days of treatment, A group of patients with the death of 11 people, C group of patients with a minimum of 6 people, the difference between the three.Conclusion:Ulinastatin can reduce in patients with severe sepsis 28 day case fatality rate of patients, shorten the hospitalization time, and inhibit the inflammatory reaction of the patient’s body, organ function in protection of patients and promote the recovery of patients with the disease and the dosage of the therapeutic effect of ulinastatin in septic patients and ulinastatin correlates well with, angel is 30 000 u Ulinastatin 60 million U / day dose dose of sepsis treatment effect is more obvious.