目的 观察血必净联合乌司他丁辅助治疗脓毒血症的临床效果.方法 选取脓毒血症患者80例,根据随机数字表法将其分为对照组与观察组各40例.两组均接受常规治疗,对照组给予血必净注射液50 mL加入生理盐水100 mL静脉滴注,每日2次;观察组给予血必净+乌司他丁治疗,血必净用药方法同对照组,乌司他丁10万U加入生理盐水100 mL静脉滴注,每日2次.两组均连续治疗10 d.分别于治疗前、治疗8d采用器官功能障碍量表Ⅱ(MarshaⅡ)评分评价患者的器官功能,采用急性生理学和慢性健康状况量表Ⅱ(APACHEⅡ)评分评价患者的健康状况;分别于治疗前及治疗4、8d用全自动血液细胞分析仪检测血常规,用全自动凝血分析仪检测凝血指标,用免疫比浊法、酶联免疫吸附法检测炎症因子;记录两组治疗10 d的生存情况.结果 治疗后两组MarshaⅡ评分、APACHEⅡ评分、血常规、凝血指标、炎症因子水平均较治疗前改善(P均＜0.05),且治疗后观察组以上指标较对照组改善明显(P均＜0.05).治疗10 d观察组生存率高于对照组(P＜0.05).结论 血必净与乌司他丁可协同减轻脓毒血症患者病情,改善其凝血功能、炎症状态,提高患者存活率.

Objective To investigate the effect of scenario simulation teaching method on medical interns in emergency department . Methods A total of 80 medical interns were randomly divided into control group and experimental group on average ,respectively trainedby traditional teaching method and scenario simulation teaching method .Two groups of students were tested by theoretical and skills examina-tion,experimental group for evaluation of scenario simulation teaching method .Results Without significant difference between twogroups in theoretical examinations scores (P>0.05),the experimental group was significantly better than the control group in skills examination scores (P<0.05).The survey results showed that more than 90 percent of students were inclined to scenario simulation teaching method .Conclu-sion Compared with the traditional teaching ,scenario simulation teaching method is better for students to master emergency knowledge .