摘要
目的:探讨连续性高通量血液滤过(HVHF)联合血必净治疗重症肺炎的疗效,为临床重症肺炎的治疗提供新的方法。方法:选择我院重症医学科2013-01~2015-01收治的70例重症肺炎患者,将其随机分为对照组和治疗组,每组35例,对照组常规行机械通气、加强抗感染、化痰、平喘、营养等对症支持治疗;治疗组在常规治疗的基础上加用连续性高通量血液滤过联合血必净治疗。比较两组治疗前及治疗后第3天、第7天的体温、白细胞计数、氧合指数、平均动脉压(MAP)、动脉乳酸盐(LAC)、降钙素原(PCT)、急性生理与慢性健康评分(APACHEⅡ)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6),以及患者机械通气时间、早期病死率变化。结果:治疗组氧合指数、MAP的维持、体温、PCT水平、LAC水平、APACHEⅡ评分、白细胞计数改善、TNF-α及IL-6下降水平均优于对照组,差异有统计学意义(P<0.05),且机械通气时间较对照组明显缩短、早期病死率下降明显,差异具有统计学意义(P<0.05)。结论:重症肺炎患者应用连续性高通量血液滤过联合血必净治疗,在维持患者血流动力学的稳定、改善肺部氧合、炎症介质的清除、缩短机械通气时间等方面优势明显,值得推广。
Objective：To explore the effect of continuous high volume hemofiltration（HVHF）combined with Xuebijing injection on severe pneumonia,and to provide new method for clinical treatment of severe pneumonia.Methods：Seventy patients with severe pneumonia from January 2013 to 2015were collected and randomly divided into control group（n=35）and treatment group（n=35）,and the control group were treated with conventional mechanical ventilation,and strengthening the resistance to infection,phlegm,asthma,such as nutrition support therapy.Treatment group were treated with HVHF and Xuebijing injection on the basis of conventional treatment.The patient’s body temperature and white blood cell（WBC）count,oxygenation index,mean arterial pressure（MAP）,the arterial lactate（LAC）,procalcitonin（PCT）,acute physiology and chronic health evaluation（APACHE Ⅱ）,the changes of TNF-αand IL-6,as well as the patients with mechanical ventilation time,early mortality changes,the difference of treatment effect were compared between the two groups at 3days,7days before and after treatment.Results：Oxygenation index,MAP of maintaining,body temperature,level of LAC and PCT,APACHE Ⅱ score,improve the WBC count,TNF-αand level of IL-6drops in treatment group were superior to control group,the difference was statistically significant（P 〈0.05）,and mechanical ventilation time was significantly shortened,early mortality rate decreased significantly（P 〈0.05）.Conclusion：Patients with severe pneumonia are given HVHF combined with Xuebijing injection has obvious advantages in maintaining the stability of hemodynamics,improve pulmonary oxygenation and mediators of inflammation,reduce the time of mechanical ventilation.It is worth promoting.
出处
《西北国防医学杂志》
CAS
2017年第5期310-314,共5页
Medical Journal of National Defending Forces in Northwest China
