摘要
目的探究连续性血液净化与间歇性血液透析治疗多器官功能障碍综合征(MODS)患者的临床疗效,观察患者生化指标及炎症因子水平变化,旨在提升MODS患者的存活率及生活质量。方法选取医院2016年6月-2018年4月收治的68例MODS患者,随机分成两组,各34例,研究组患者接受连续性血液净化治疗,对照组患者接受间歇性血液透析治疗。观察两组患者的临床疗效,记录患者治疗前后生化指标、炎症因子及马歇尔·霍尔氏病(Marshall)评分变化。结果两组治疗后的BUN、Cr、HCO_3、pH均优于治疗前(P<0.05),且治疗后1d、2d、3d研究组BUN、Cr、HCO_3生化指标水平均优于对照组(P<0.05);治疗后1d、2d两组pH值比较无差异,但治疗3d后研究组的pH值高于对照组(P<0.05);研究组患者每日的补液摄入量多于对照组,充血性心力衰竭发生率低于对照组(P<0.05);治疗后6h、24h、48h,研究组炎症因子IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0.05);治疗后研究组Marshall评分低于对照组(P <0.05)。结论连续性血液净化治疗MODS患者的临床效果优于间歇性血液透析治疗,可促进BUN、Cr、HCO_3、pH各生化指标稳定,降低外周血细胞因子水平和Marshall评分,具有很好的应用价值。
OBJECTIVE To observe the clinical effects of continuous blood purification and intermittent hemodialysis on treatment of patients with multiple organ dysfunction syndrome(MODS)and investigate the levels of biochemical indexes and inflammatory factors so as to raise the survival rate and quality of life of the patients with MODS.METHODS A total of 68 patients with MODS who were treated in the hospital from Jun 2016 to Apr 2018 were enrolled in the study and randomly divided into two groups,with 34 cases in each group.The study group was treated with continuous blood purification,while the control group was treated with intermittent hemodialysis.The clinical effects of the two groups of patients were observed,and the levels of biochemical indexes and inflammatory factors as well as Marshall scores of the patients were recorded before and after the treatment.RESULTS BUN,Cr,HCO3,and pH of the two groups of patients were better after the treatment than before the treatment,and the levels of biochemical indexes BUN,Cr and HCO3 of the study group were better than those of the control group after the treatment for 1,2 and 3 days(P<0.05).There was no significant difference in the pH value between the two groups after the treatment for 1 and 2 days,however,the pH value of the study group was significantly higher than that of the control group after the treatment for 3 days(P<0.05).The daily fluid intake of the study group was significantly more than that of the control group,and the incidence of congestive heart failure of the study group was lower than that of the control group(P<0.05).The levels of inflammatory factors IL-6 and TNF-αof the study group were lower than those of the control group after the treatment for 6,24 and 48 hours,and there were significant differences(P<0.05);the Marshall scores of the study group were significantly lower than those of the control group after the treatment(P<0.05).CONCLUSION The continuous blood purification can achieve more remarkable clinical effect on treatment of the patients with MODS than the intermittent hemodialysis,it may promote the stability of BUN,Cr,HCO3 and pH and reduce the levels of peripheral blood cytokines as well as Marshall scores,with the application value high.
作者
江瑞
范德墉
凌扣荣
JIANG Rui;FAN De-yong;LING Kou-rong(Huzhou Central Hospital,Huzhou,Zhejiang313000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2019年第9期1342-1346,共5页
Chinese Journal of Nosocomiology
基金
浙江省医药卫生科技计划基金资助项目(2016ZHA005)
关键词
连续性血液净化
间歇性血液透析
多器官功能障碍综合征
生化指标
外周血细胞因子
Continuous blood purification
Intermittent hemodialysis
Multiple organ dysfunction syndrome
Biochemical index
Peripheral blood cytokine
