摘要
目的分析ICU感染性休克患者在就诊期间选择不同持续性肾脏替代疗法(continuous renal replace‐ment therapy,CRRT)治疗剂量的影响。方法选取2022年9月—2023年9月山东省莱西市人民医院收治的76例ICU感染性休克患者作为研究对象,根据随机数表法分为大剂量组和小剂量组,各38例,前一组行大剂量CRRT治疗,后一组行小剂量CRRT治疗,比较两组应激反应、炎症因子、免疫功能及转归情况。结果治疗后,大剂量组丙二醛、髓化过氧化物酶水平低于小剂量组,差异有统计学意义(P<0.05)。治疗后,大剂量组的CD4+、CD3+水平高于小剂量组,差异有统计学意义(P<0.05)。治疗前后两组CD8+水平比较,差异无统计学意义(P>0.05)。大剂量组多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)发生率为7.89%,7 d内死亡率为2.63%,均低于小剂量组,差异有统计学意义(χ^(2)=4.828、5.029,P<0.05)。大剂量组ICU治疗时间短于小剂量组,差异有统计学意义(P<0.05)。结论大剂量CRRT治疗效果更明显,能减少MODS事件发生,提高患者生存率,增强免疫功能,减轻炎症和应激反应,利于改善ICU感染性休克患者预后。
Objective To analyze the effects of different doses of continuous renal replacement therapy(CRRT)in pa‐tients with septic shock in ICU.Methods A total of 76 patients with septic shock in ICU in Laixi People's Hospital of Shandong Province from September 2022 to September 2023 were selected as the study objects.According to random number table method,they were divided into high-dose group and low-dose group,with 38 cases in each group.The former group received high-dose CRRT treatment,and the latter group received low-dose CRRT treatment.The stress response,inflammatory factors,immune function and outcomes of the two groups were compared.Results After treat‐ment,the levels of malonaldehyde and myeloperoxidase in the high-dose group were lower than those in the low-dose group,and the differences were statistically significant(P<0.05).After treatment,the level of CD4+and CD3+in highdose group were higher than those in low-dose group,and the differences were statistically significant(P<0.05).There was no statistically significant difference in CD8+level between the two groups before and after treatment(P>0.05).The incidence of multiple organ dysfunction syndrome(MODS)in the high-dose group was 7.89%,and the mor‐tality within 7 d was 2.63%,both of which were lower than those in the low-dose group,and the differences were sta‐tistically significant(χ^(2)=4.828,5.029,P<0.05).The duration of ICU treatment in high-dose group was shorter than that in low-dose group,and the difference was statistically significant(P<0.05).Conclusion The therapeutic effect of high-dose CRRT is more obvious,which can reduce the occurrence of MODS,improve the survival rate of patients,en‐hance immune function,reduce inflammation and stress response,and help improve the prognosis of patients with sep‐tic shock in ICU.
作者
葛顺舟
刘洪敬
王海波
GE Shunzhou;LIU Hongjing;WANG Haibo(Department of Critical Care Medicine,Laixi People's Hospital,Laixi,Shandong Province,266600 China)
出处
《系统医学》
2023年第21期83-86,共4页
Systems Medicine
关键词
感染性休克
转归情况
持续性肾脏替代疗法
应激反应
治疗剂量
Infectious shock
Regression
Continuous renal replacement therapy
Stress response
Therapeutic dose
