连续血液净化治疗严重脓毒症患儿的临床疗效及其对细胞免疫功能及炎症因子水平的影响  

Clinical Effect of Continuous Blood Purification on Children with Severe Sepsis and Its Effect on Cellular Immune Function and Levels of Inflammatory Factors*

作　　者：朱秀洁 蔡丽霞 ZHU Xiu-jie;CAI Li-xia(Children's Intensive Care Unit,Anyang Maternal and Child Health Care Hospital,Anyang 455000,Henan Province,China)

机构地区：[1]安阳市妇幼保健院儿童重症监护室,河南安阳455000

出　　处：《罕少疾病杂志》2025年第4期161-163,167,共4页Journal of Rare and Uncommon Diseases

基　　金：河南医学科技攻关计划联合共建项目(LHGJ20203257)。

摘　　要：目的探讨给予严重脓毒症患儿连续血液净化治疗后的临床效果及对患儿细胞免疫功能、血流动力学及炎症因子水平的影响。方法选取我科2021年7月至2022年11月期间97例严重脓毒症患儿作为研究对象,根据随机数字表法分为对照组和观察组。其中对照组患儿48例给予常规治疗;观察组患儿49例增加连续血液净化治疗,对比两组患儿临床疗效、细胞免疫功能、炎症因子水平、并发症总发生率。结果但两组患者治疗后总病死人数对比无明显差异(P>0.05);治疗后观察组患者CD3+、CD4+百分比、CD4+/CD8+比值均高于对照组(P<0.05);治疗后观察组患者血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏-C反应蛋白(hs-CRP)水平均低于对照组(P<0.05);治疗后两组患者并发症总发生率对比无明显差异(P>0.05)。结论应用连续血液净化治疗严重脓毒症患儿,既可保证患者的临床治疗效果不受影响,又有助于改善患者的免疫功能水平,降低患者的炎症水平无统计学意义。Objective To investigate the clinical effects of continuous blood purification therapy in children with severe sepsis and the effects on the cellular immune function,hemodynamics and levels of inflammatory factors.Methods A total of 97 children with severe sepsis in our department from July 2021 to November 2022 were selected as research objects and divided into control group and observation group according to random number table method.48 children in the control group received conventional treatment;49 cases in the observation group were added continuous blood purification therapy,and the clinical efficacy,cellular immune function,inflammatory factor levels and the total incidence of complications were compared between the two groups.Results There was no significant difference in the total number of deaths between the two groups after treatment(P>0.05).After treatment,the percentages of CD3+and CD4+and the ratio of CD4+/CD8+in observation group were higher than those in control group(P<0.05).After treatment,the serum levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and hypersensitive C-reactive protein(hs-CRP)in observation group were lower than those in control group(P<0.05).There was no significant difference in the total incidence of complications between the two groups after treatment(P>0.05).Conclusion blood purification in the treatment of children with severe sepsis can not only ensure the clinical therapeutic effect of patients,but also help to improve the level of immune function of patients.There is no statistical significance in reducing the level of inflammation in patients.

关 键 词：连续血液净化治疗 脓毒症 临床疗效 免疫功能 血流动力学 炎症因子 

分 类 号：R714.626[医药卫生—妇产科学]