连续性肾脏替代疗法在烧伤创面脓毒症中的应用  

The application of continuous renal replacement therapy in burn wound sepsis

作　　者：唐亦复 杨月丽 胥学冰[1] 张博[1] 侯雨杉 陈冬梅[1] TANG Yi-fu;YANG Yue-li;XU Xue-bing;ZHANG Bo;HOU Yu-shan;CHEN Dong-mei(Department of Burn,Liaoning Provincial Corps Hospital of PAP,Shenyang 110034,China)

机构地区：[1]武警辽宁总队医院烧伤科,辽宁沈阳110034

出　　处：《武警后勤学院学报（医学版）》2018年第2期125-127,共3页Journal of Logistics University of PAP（Medical Sciences）

摘　　要：【目的】探讨连续性肾脏替代疗法在烧伤创面脓毒症中的应用。【方法】回顾分析我院2005年5月至2017年9月收治的66例大面积烧伤合并创面脓毒症患者,按治疗方案不同分为对照组33例和连续性肾脏替代疗法(continuous renal replacement therapy,CRRT)组33例。对照组常规综合治疗,随后急诊行切痂植皮术,术后继续常规治疗;实验组在常规综合治疗的基础上联合连续肾脏替代治疗,随后行切痂植皮术,术后继续CRRT治疗。观察两组患者治疗前及治疗后24、48、72 h生命体征(体温、心率、呼吸、血压)、血清生化指标(钠、氯、尿素N、肌酐)及病死率。【结果】CRRT组治疗后48 h及术后48 h各项生命体征趋于平稳,血清生化指标下降,与对照组相比差异有统计学意义(P<0.05)。对照组病死率(84.8%)明显高于CRRT组(33.3%),差异有统计学意义(P<0.01)。【结论】CRRT可改善烧伤创面脓毒症患者一般情况和各项生化指标,有效控制全身感染,为切痂手术提供手术时机,明显提高抢救成功率,是一种行之有效的辅助治疗手段。【Objective】To explore the application of continuous renal replacement therapy（CRRT） in burn wound sepsis.【Methods】A total of 66 cases with extensive burn and wound sepsis were retrospectively analyzed in our hospital from May 2005 to September2017. According to the therapeutic regimen, the patients were divided into control group（33 cases） and CRRT group（33 cases）. The patients in the control group were given routine comprehensive treatment, emergency escharectomy and postoperative routine treatment.Those in the CRRT group were treated with routine comprehensive treatment and CRRT. Then they underwent emergency escharectomy and postoperative CRRT. Vital signs（temperature, heart rate, respiration and blood pressure）, serum biochemical parameters（sodium,chloride, urea nitrogen and creatinine） and mortality between the two groups were observed before the treatment and at 24 h, 48 h,72 h after the treatment.【Results】After 48 h of the treatment, the vital signs tended to be stable and the serum biochemical parameters declined in the CRRT group. There was a significant difference between the two groups（P〈0.05）. The mortality in the control group（84.8%） was significantly higher than that in the CRRT group（33.3%）, and the difference was significant（P0.01）.【Conclusion】CRRT can improve the general situation and biochemical indexes in the patients with burn wound sepsis, and effectively control the systemic infection. It can provide the opportunity for escharectomy, and obviously improve the success rate of rescue. Therefore, it is an effective assistant therapeutic measure.

关 键 词：烧伤 创面脓毒症 连续性肾脏替代疗法 

分 类 号：R644[医药卫生—外科学]