摘要
目的:观察床旁连续性静脉-静脉血液滤过(CVVH)治疗对急性呼吸窘迫综合征(ARDS)患者炎症因子水平及动脉血气的影响。方法:将76例ARDS患者,采用随机数字表法分为观察组40例与对照组36例,对照组患者给予基础治疗,观察组患者在基础治疗的基础上给予CVVH治疗,对比2组患者治疗前、后肿瘤坏死因子(TNF-α)、C-反应蛋白(CRP)、白介素-6(IL-6)水平及动脉血气分析。结果:与治疗前比较,治疗后观察组患者的APACHEⅡ评分明显降低,且低于对照组治疗后(P<0.05),对照组患者治疗前、后APACHEⅡ评分无显著变化;治疗后2组患者的TNF-α、CRP、IL-6、PaO_2、SaO_2、PaCO_2、HCO_3^-、氧合指数水平均明显改善,且观察组较对照组改善更显著(P<0.05);观察组半年生存率显著高于对照组(65.0%vs 47.2%,P<0.05)。结论:对于ARDS患者在基础治疗上联合应用CVVH治疗能够显著提高炎症因子清除效果,改善凝血和呼吸功能,提高疗效。
Objective： To analyze the effect of bedside continuous veno venous hemofiltration（ CVVH） on the levels of inflammatory cytokines and arterial blood gas in patients with acute respiratory distress syndrome（ ARDS）. Methods： From August 2014 to December 2015 in our hospital,76 cases of ARDS were randomly divided into observation group and control group. The patients in the control group and observation group were given basic treatment,and those in the observation group were treated with CVVH additionally. The tumor necrosis factor-alpha（ TNFα）,C-reactive protein（ CRP）,interleukin-6（ IL-6） and the arterial blood gas analysis were compared. Results The APACHE scores were significantly reduced in the observation group after treatment as compared with those before treatment,and significantly lower than those in the control group after treatment（ P〈0.05）. There was no significant difference before and after treatment in the control group. TNFα,CRP,IL-6,PaO_2,SaO_2,Pa CO_2,HCO_3--,and oxygenation index were significantly improved after treatment in both two groups,more significantly in the observation group than in the control group（ P〈0. 05）. The six-month survival rate in the observation group was 65%,significantly higher than in the control group（ P〈0.05）. Conclusion： For patients with ARDS,the basic treatment combined with CVVH treatment can more effectively clean the inflammatory factors,and improve the coagulation and respiratory functions to obtain more satisfactory therapeutic effects.
出处
《内科急危重症杂志》
2017年第1期37-39,共3页
Journal of Critical Care In Internal Medicine
关键词
连续性静脉-静脉血液滤过
急性呼吸窘迫综合征
炎症因子
血气分析
Continuous veno-venous hemofiltration
Acute respiratory distress syndrome
Inflammatory factors
Blood gas analysis
