连续性肾脏替代治疗在重症多脏器功能衰竭患者中的应用效果及对炎症反应的控制作用  

Application effect of continuous renal replacement therapy in patients with severe multiple organ failure and its control effect on inflammatory response

作　　者：李鹏 王存真[2] 王飞 LI Peng;WANG Cunzhen;WANG Fei(Critical Care Department,the People's Hospital of Yanling County,Xuchang 461200;Critical Care Department,Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]鄢陵县人民医院重症医学科,河南许昌461200 [2]河南省人民医院重症医学科,河南郑州450000

出　　处：《临床医学研究与实践》2022年第21期45-48,共4页Clinical Research and Practice

摘　　要：目的观察连续性肾脏替代治疗(CRRT)在重症多脏器功能衰竭患者中的应用效果及对炎症反应的控制作用。方法选择2019年1月至2020年12月收治的70例重症多脏器功能衰竭患者为研究对象,利用计算机数字随机模型将其分为对照组和观察组,每组35例。对照组采取常规对症治疗,观察组在此基础上采取CRRT。比较两组的白细胞计数、呼吸频率、心率、氧分压、炎症因子水平、不良反应发生情况、肾功能指标及肝功能指标。结果治疗后,观察组的白细胞计数、呼吸频率、心率低于对照组和治疗前,氧分压高于对照组和治疗前,差异具有统计学意义(P<0.05)。治疗后,两组的超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、免疫球蛋白E(IgE)、高迁移率族蛋白1(HMGB-1)水平均低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。观察组的不良反应总发生率为5.71%,低于对照组的28.57%,差异具有统计学意义(P<0.05)。治疗后,两组的尿素氮(BUN)、血肌酐(SCr)、β2微球蛋白(β2-MG)水平及尿白蛋白排泄率(UAER)均低于治疗前,且观察组低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组的白蛋白(ALB)水平及凝血酶原活动度(PTA)均高于治疗前,丙氨酸转氨酶(ALT)、总胆红素(TBIL)水平均低于治疗前,且观察组优于对照组,差异具有统计学意义(P<0.05)。结论采用CRRT对重症多脏器功能衰竭患者进行治疗,能够改善白细胞计数、呼吸频率、心率、氧分压,减轻炎症反应,改善肾、肝功能,且安全性较高。Objective To observe the application effect of continuous renal replacement therapy(CRRT)in patients with severe multiple organ failure and its control effect on inflammatory response.Methods Seventy patients with severe multiple organ failure admitted from January 2019 to December 2020 were selected as the research objects.The patients were divided into control group and observation group by computer numerical random model,with 35 cases in each group.The control group was given routine symptomatic treatment,while the observation group was given CRRT on this basis.The white blood cell count,respiratory rate,heart rate,oxygen partial pressure,inflammatory factors levels,adverse reactions,renal function indexes and liver function indexes were compared between the two groups.Results After treatment,the white blood cell count,respiratory rate and heart rate in the observation group were lower than those in the control group and before treatment,the oxygen partial pressure was higher than that in the control group and before treatment,and the differences were statistically significant(P<0.05).After treatment,the levels of hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),immunoglobulin E(IgE)and high mobility group box-1 protein(HMGB-1)in the two groups were lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in the observation group was 5.71%,which was lower than 28.57%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of blood urea nitrogen(BUN),serum creatinine(SCr),β2-microglobulin(β2-MG)and urinary albumin excretion rate(UAER)in the two groups were lower than those before treatment,those in the observation group were lower than the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of albumin(ALB)and prothrombin activity(PTA)in the two groups were higher

关 键 词：连续性肾脏替代治疗 重症多脏器功能衰竭 炎症反应 

分 类 号：R459.7[医药卫生—急诊医学]