连续性血液净化在感染性多器官功能障碍综合征中的疗效观察  

Efficacy of continuous blood purification in infectious MODS

作　　者：张磊[1] 

机构地区：[1]天津市第一中心医院ICU,天津300192

出　　处：《中华医院感染学杂志》2011年第16期3403-3405,共3页Chinese Journal of Nosocomiology

摘　　要：目的探讨连续性血液净化在感染性多器官功能障碍综合征(MODS)中的疗效。方法选取2007年1月-2010年12月进行治疗的42例感染性MODS患者为研究对象,将其随机分为对照组(间歇性血液透析组)和观察组(连续性血液净化组)各21例,将两组患者的好转率及治疗前后的血尿素氮(BUN)、肌酐(Cr)、中心静脉压(CVP)、平均动脉压(MAP)、慢性健康状况评分Ⅱ评分(APACHEⅡ评分)、肿瘤坏死因子α(TNF-α)、白介素-4(IL-4)、白介素-6(IL-6)、白介素-8(IL-8)、C-反应蛋白(CRP)水平进行统计及比较。结果观察组的好转率为85.71%,高于对照组的57.14%,观察组的BUN为(16.52±4.02)mmol/L,Cr为(32.42±3.57)mmol/L,CVP为(12.59±6.75)cm H2O,APACHEⅡ评分为(13.4±3.6)分,TNF-α为(16.52±4.02)pg/ml,CRP为(10.47±3.72)mg/L,IL-4I、L-6I、L-8分别为(25.68±6.62)(、22.38±7.15)、(24.38±14.97)pg/ml,两组比较,差异均有统计学意义(均P<0.05),观察组MAP为(74.12±5.76)mm Hg,高于对照组的(69.85±7.58)mm Hg,差异有统计学意义(P<0.05)。结论连续性血液净化在感染性MODS中的疗效较好,对于改善患者的预后有着积极的作用。OBJECTIVE To study the effects of continuous Blood Purification in infectious MODS.METHODS A total of 42 patients with infectious MODS from Jan 2007 to Dec 2010 were selected as research object,and they were randomly divided into control group（intermittent hemodialysis group）21 cases and observation group（Continuous Blood Purification group）21 cases,then the improvement rate and BUN,SCr,CVP,MAP,APACHEⅡ score,TNF-α,IL-4,IL-6,IL-8,CRP of two groups before and after the treatment were analyzed and compared.RESULTS The improvement rate of observation group（85.71%）was higher than that of control group（57.14%）.In observation group,BUN was（16.52±4.02）mmol/L,Cr was（32.42±3.57）mmol/L,CVP was（12.59±6.75） cmH2O,the score of APACHEⅡ was（13.40±3.60）,TNF-α（16.52±4.02） pg/ml,CRP（10.47±3.72） mg/L,the scores of IL-4,IL-6,IL-8 were（25.68±6.62）,22.38±7.15）,（24.38±14.97） pg/ml,respectively.MAP was higher than that of control group（74.12±5.76 vs 69.85±7.58） mm Hg,there were significant differences or very significant differences.CONCLUSION The effect of continuous blood purification in infectious MODS is good,and it plays an important role in improving prognosis of patients.

关 键 词：连续性血液净化 感染性 多器官功能障碍综合征 疗效 

分 类 号：R181.32[医药卫生—流行病学]