持续肾脏替代治疗在严重脓毒症儿童中应用及安全性研究  

The usage of continuous renal replacement therapy and the effect of it on the efficacy and safety in pediatrics with sever Sepsis

作　　者：万秋清[1] 候小芹[1] 晏萍兰[1] WAN Qiuqing;HOU Xiaoqing;YAN Pinglan(Department of PICU,Jiangxi Children's Hospital,Nanchang,Jiangxi,330008,China)

机构地区：[1]江西省儿童医院PICU,江西南昌330008

出　　处：《当代医学》2022年第33期107-110,共4页Contemporary Medicine

摘　　要：目的探讨持续肾脏替代治疗(CRRT)严重脓毒症患儿的疗效及其安全性。方法选取2016年5月至2019年5月于本院诊断为严重脓毒症的42例患儿作为研究对象,随机分为两组,每组21例。A组在常规治疗基础上使用CRRT,B组仅采用常规治疗,比较两组治疗前后炎症因子指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]、住院时间及A组CRRT治疗前后血压及凝血功能指标。结果治疗后,A组病死率为9.5%(2/21),明显低于B组的28.6%(6/21),差异有统计学意义(P<0.05)。A组住院时间为(24.4±4.5)d,短于B组的(36.9±6.5)d,差异有统计学意义(P<0.05)。A组治疗前后血压、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)比较差异无统计学意义。治疗前,两组TNF-α,IL-1,IL-6,IL-10水平比较差异无统计学意义;治疗后,A组TNF-α,IL-1,IL-6,IL-10分别为(62.62±8.22)、(118.9±13.5)、(159.6±29.0)、(122.0±7.0)ng/L,均明显低于B组的(180.43±26.37)、(341.6±31.5)、(286.05±31.9)、(335.9±63.1)ng/L,差异均有统计学意义(P<0.05)。结论CRRT治疗脓毒症患儿,能较好地清除患儿炎症因子,缩短住院时间,改善预后,且对患儿血压及凝血功能影响较小,安全性高,值得儿科临床推广应用。Objective To study and investigate the effect of continuous renal replacement therapy(CRRT)on thecurative effect and safety in-Pediatrics with sepsis,to provide the basis forclinical.Methods A total of 42 children diagnosed with severe sepsis in our hospital from May 2016 to May 2019 were selected as research subjects,and they were randomly divided into two groups with 21 cases in each group.The group A was given CRRT treatment onthe basis of conventional therapy,the group B was giventhe basis of conventional therapy,the improvement of inflammatory factors(tumor necrosis factor-α[TNF-α],interleukin-1[IL-1],interleukin-6[IL-6],interleukin-10[IL-10]),length of hospitalization were compared between the two groups,and the blood pressure and coagulation function before and after CRRT treatment were compared in group A.Results After treatment,the total effectiverate of the A group was 94.0%(20/21),which was significantly higher than 78.0%(15/21)of the B group,the difference was statistically significant(P<0.05).The length of hospitalization in group A was(24.4±4.5)d,which was shorter than that in group B(36.9±6.5)d,and the difference was statistically significant(P<0.05).There was no significant difference in blood pressure,activated partial thromboplastin time(APTT)and prothrombin time(PT)in group A before and after treatment.Before treatment,there were no significant differences in the levels of TNF-α,IL-1,IL-6 and IL-10 between the two groups.After treatment,TNF-α,IL-1,IL-6 and IL-10 in group A were(62.62±8.22),(118.9±13.5),(159.6±29.0)and(122.0±7.0)ng/L,respectively.They were significantly lower than those in group B(180.43±26.37),(341.6±31.5),(286.05±31.9)and(335.9±63.1)ng/L,the difference was statistically significant(P<0.05).Conclusion CRRT is used in the treatment of children with sepsis,which can better clear inflammatory factors,shorten the length of hospital stay,improve the prognosis of children,and has little influence on blood pressure and coagulation function of children,with high safety,wo

关 键 词：严重脓毒症儿童 连续肾脏替代治疗 血压 凝血功能 

分 类 号：R459.7[医药卫生—急诊医学]