| Objective: To explore the clinical effect of glucose-insulin-potassium combined with Shenmai injection in the treatment of sepsis-related myocardial damage.Methods: Sixty-two patients with sepsis(abdominal cavity,lung,urinary system,and soft tissue infection)and myocardial damage who were admitted to the ICU ward of Affiliated Hospital of Changchun University of Traditional Chinese Medicine between October 2018 and December 2019 were selected as the research subjects.Envelope method was used to randomly divide 30 cases of glucose-insulin-potassium treatment group(control group)and 32 cases of glucose-insulin-potassium combined with Shenmai injection treatment group(combination group).The two groups were referred to the 2018 guidelines for the diagnosis and treatment of sepsis,and were given treatment for the primary disease,control infection,stabilize hemodynamics,protect various organ functions,and support nutrition.The control group added to glucose-insulin-potassium protect myocardial function on the basis of the above treatment,q/d for 7 consecutive days;the combined group added glucose-insulin-potassium and Shenmai injection to protect myocardial function on the basis of the above treatment group,q/d for 7consecutive days.Observe the changes of serum markers related to myocardial damage in the two groups of patients before and on the first,third,and seventh days of treatment;observe the changes in cardiac function indicators of cardiac ultrasound before and after 7 days of treatment;observation of other clinical indicators: duration of ventilator use,duration of vasoactive drug use,length of ICU stay,28-day mortality;observation of organ function scores before and after7 days of treatment in the two groups: changes in SOFA scores and APACHEII scores.Results:1 Before treatment,there were no statistical differences in gender,age,underlying disease,infection site,APACHE II score,SOFA score at the time of enrollment(P> 0.05),and they were comparable.2 Plasma c Tn I,c Tn T,and NT-pro BNP levels were lower in the two groups after treatment than before treatment(P <0.05 or P <0.01);in the combined group,c Tn T,NT-pro BNP levels were lower on the 3rd day after treatment than in the control group.Significant differences occurred(P=0.018,P=0.013),and c Tn I declines were significantly different on the 7th day after treatment(P<0.01).3 On the 7th day of treatment,the LVEF and E / A indicators of the two groups were higher than before treatment;E / e ’,LVEDD,and LVESD indicators were lower than before treatment(P<0.05 or P<0.01);and the combined group LVEF and E / A,E / e ’,LVEDD,and LVESD indicators were significantly different from those in the control group(P = 0.007,P=0.000,P=0.030,P= 0.002,P=0.000).4 There was no significant difference in the time of mechanical ventilation and application of vasoactive drugs after treatment between the control group and the treatment group(P=0.346,P= 0.100),but the patients in the combination group showed a shorter trend than those in the control group.5 There was no significant difference in ICU stay and 28-day mortality between the control group and the combination group(P =0.370,P=0.322).6 The APACHE Ⅱ score and SOFA score of the two groups of patients were decreased after treatment for 7 days(P<0.01),and the APACHE Ⅱ score and SOFA score of the combined group were significantly lower than those of the control group(P <0.01).Conclusions:1.Both glucose-insulin-potassium combined with Shenmai injection and glucose-insulinpotassium alone can improve myocardial function in patients with myocardial damage in sepsis and play a protective effect on myocardium in patients with sepsis myocardial damage;2.Combined Shenmai injection treatment is more effective than glucose-insulinpotassium alone,and the time of mechanical ventilation and vasoactive drugs is shortening,but it has no effect on the prognosis of patients. |
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