早期CRRT干预对重症肺炎患者肺保护作用的临床观察.docVIP

早期CRRT干预对重症肺炎患者肺保护作用的临床观察 　　[摘要] 目的 观察早期CRRT干预对重症肺炎患者肺的保护作用。方法 将52例重症肺炎患者随机均分为CRRT组和对照组，对照组进行常规抗感染对症支持治疗，CRRT组在常规治疗基础上加早期CRRT治疗，记录两组患者治疗前及治疗后1 d、3 d、7 d动脉血PH值、氧饱和度（SaO2）、气道平台压力值、血清炎症介质白介素6（IL-6）及血浆降钙素原（PCT）数值，并统计分析治疗的有效率。 结果 CRRT组患者治疗后1 d、3 d和7 d的血清IL-6及PCT均较对照组明显降低（P0.05），两组治疗后上述指标均较治疗前明显改善（P0.05）；CRRT组治疗总有效率高于对照组，差异有统计学意义（P0.05）。 结论 早期CRRT干预能有效减轻重症肺炎患者肺损伤，加强肺保护，是一种有效的辅助治疗措施，值得推广。 　　[关键词] CRRT；重症肺炎；肺保护；临床疗效 　　[中图分类号] R563.1；R692 [文献标识码] B [文章编号] 1673-9701（2014）31-0141-03 　　Clinical observation and assessment analysis of early continuous renal replacement treatment （CRRT） for severe pneumonia 　　YU Yu SHA Fenfang ZHOU Xianglian LIN Mengxiang 　　Department of Intensive Care Unit， the Second Affiliated Hospital of Wenzhou Medical University， Wenzhou 325027， China 　　[Abstract] Objective To observe the clinical efficacy of early continuous renal replacement treatment （CRRT） for severe pneumonia. Methods Fifty-two cases of patients with severe pneumonia were included in this research， they were randomly divided into two groups（each n=26）， control group was treated with conventional anti infection and supportive treatmen， while the CRRT group was further treated by early CRRT. the arterial blood pH， oxygen saturation（SaO2）， plateau airway pressure， serum cytokine interleukin 6（IL-6） and plasma procalcitonin （PCT） at different time points，meanwhile the treatment efficiency was statistical analyed. Results The serum IL-6 and PCT in CRRT group were lower than in the control group at 1 d， 3 d and 7 d after treatment （P0.05）； All these indicators were improved significantly after treatment （P0.05）； In addition the total effective rate in CRRT group was higher than the control group（P0.05）. Conclusion Early CRRT intervention can effectively reduce the lung injury in patients with severe pneumonia， it is an effectively adjuvant method in rescuing severe pneumonia， which could bring out satisfactory outcome. 　　[Key words] Continuous renal replacement therapy； Severe pne