摘要
目的：探讨连续性血液滤过（CRRT）不同治疗剂量对严重脓毒症患者细胞因子清除及预后的影响。方法：选取2014年1月-2015年10月我院ICU收住院因严重脓毒症患者行CRRT治疗的80例患者作为研究对象,随机分为A组和B组,A组患者采用高剂量即滤出液剂量≥35 ml/（kg·h）治疗,B组采用低剂量即滤出液量〈35 ml/（kg·h）治疗。治疗前及CRRT治疗48 h后采集血样常规送检获得两组患者血气、肝肾功能以及细胞因子IL-1β,IL-6,IL-10,TNF-α等指标,同时记录慢性健康状况评分（APACHEⅡ评分）情况。结果：CRRT治疗48 h后,心率、乳酸、肌酐、尿素氮以及ALT和APACHE Ⅱ评分比较,A组的降低值高于B组;细胞因子IL-1β,IL-6,TNF-α的降低值A组高于B组。两组患者的28 d生存率比较差异无统计学意义,但A组患者机械通气时间及ICU住院时间少于B组患者。结论：严重脓毒症患者CRRT能有效地清除细胞因子,减少机械通气及ICU住院时间。
Objective： To explore the influence of different therapeutic doses of continuous renal replacement therapy（ CRRT） on cytokines scavenging and prognosis of severe sepsis patients. Methods： Selected 80 inpatients receiving CRRT for severe sepsis in ICU of our hospital from January 2014 to October2015 as research objects,randomly divided them into group A and group B. Group A patients adopted treatment of high dose referring to percolate dose≥35 ml/（ kg·h）,while group B adopted treatment of low dose referring to percolate dose ≤35 ml/（ kg·h）. Before the treatment and 48 hours after the treatment,collected blood sample for routine examination,obtained indicators of blood gas,hepatic and renal function and cytokines IL- 1β,IL- 6,IL-10 and TNF- α of patients in the two groups,and simultaneously recorded chronic health condition score（ APACHE Ⅱscore） condition. Results： Compared the heart rate,lactic acid,creatinine,urea nitrogen,ALT and APACHE Ⅱscores 48 hours after CRRT,the reduced value of group A was higher than that of group B; the reduced values of cytokines IL- 1β,IL- 6 and TNF- α of group A were higher than those of group B. The difference in 28 d survival rates of patients in the two groups was of no statistical significance,but the mechanical ventilation time and ICU stay of group A were shorter than those of group B. Conclusion： CRRT on severe sepsis patients can effectively clear cytokines,and shorten mechanical ventilation and ICU stay.
出处
《护理实践与研究》
2016年第17期67-69,共3页
Nursing Practice and Research
