早期连续性肾脏替代治疗严重脓毒症患者效果研究.docVIP

早期连续性肾脏替代治疗严重脓毒症患者效果研究 　　[摘要] 目的 探讨早期连续性肾脏替代治疗（CRRT）严重脓毒症患者的效果。 方法 选取2014年9月～2016年9月广东省佛山市禅城区中心医院ICU科收治的100例严重脓毒症患者，回顾性分为对照组和治疗组，各50例。对照组采用常规疗法，而治疗组则在对照组基础上进行早期（做出诊断6 h内）连续性肾脏替代治疗（CRRT）。比较两组患者炎症因子、免疫指标、预后指标（APACHEⅡ评分、SOFA评分及氧合指数）情况。 结果 治疗7 d后，治疗组CRP水平明显低于对照组（P 0.05），而CD4+/CD8+、IgA水平则明显高于对照组（P 0.05）。治疗组APACHⅡ评分、SOFA评分均明显低于对照组（P 0.05），但氧合指数明显高于对照组（P 0.05）。 结论 严重脓毒症患者早期进行CRRT治疗，不仅可以清除过度表达的炎症介质，提高T细胞功能和改善免疫功能紊乱，而且可以改善患者预后，值得在临??推广应用。 　　[关键词] 脓毒症；连续性肾脏替代治疗；免疫功能；治疗效果 　　[中图分类号] R495.5 [文献标识码] A [文章编号] 1673-7210（2017）05（b）-0099-04 　　[Abstract] Objective To explore the curative effect of early continuous renal replace therapy （CRRT） for severe sepsis patients. Methods 100 cases of severe sepsis patients were chosen in ICU Department of Central Hospital of Chancheng District in Foshan City from September 2014 to September 2016， and these patients were divided into the control group and treatment group retrospectively， each group had 50 cases. The control group was given conventional treatment， and the treatment group was given early CRRT （within 6 hours of diagnosis） on the basis of the control group. The indexes of inflammatory factors， immunization and prognosis （APACHEⅡ score， SOFA score and oxygenation index） were compared between the two groups. Results After 7 days treatment， the level of CRP in the treatment group was lower than that in the control group （P 0.05）， but the levels of CD4+/CD8+ and IgA in the treatment group were higher than those in the control group （P 0.05）. The scores of APACHⅡ and SOFA in the treatment group were lower than those in the control group （P 0.05）， but oxygenation index was higher than that in the control group （P 0.05）. Conclusion Severe sepsis patients treated by early CRRT， not only can eliminate over-expressed inflammatory mediators， improve T cell function and immune function disorder， but also improve prognosis of sepsis. It is worthy of clincal application. 　　[Key words] Sepsis； Continuous renal replace therapy； Immun