药用炭片联合血液净化治疗对重症腹腔感染术后患者肾功能、炎性介质、氧合指数及肠屏障功能的影响

摘要

Objective To investigate the effect of medicinal charcoal tablets combined with blood purification therapy on on renal function, inflammatory mediators, oxygenation index and intestinal barrier function in patients postoperative severe abdominal infection.Methods 65 cases with severe abdominal infection from the hospital were selected and randomly divided into control group (32 cases) and experiment group (33 cases) by random digital table method.The control group were treated by clinical routine therapy and experiment group were treated on the basis of control group with medicinal charcoal tablets combined with blood purification therapy.The renal function, inflammatory mediators, oxygenation index, intestinal barrier function and efficacy were tested.ResuIts Compared with control group after treatment, the renal function of serum creatinine (Scr), blood urea nitrogen (BUM), uric acid (UA) levels were lower (P<0.05), the inflammatory mediators of tumor necrosis factor α(TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) levels were lower (P<0.05), the oxygenation index (OI) was higher(P<0.05), the intestinal barrier function indicators of plasma diamine oxidase (DAO) and endotoxin of lipopolysaccharide (LPS) were lower (P<0.05), the total efficiency were higher (χ2 =3.91, P<0.05) in experimental group.ConcIusion The medicinal charcoal tablets combined with blood purification could effectively improve renal function, reduce inflammatory mediators levels, improve intestinal barrier function, and increase oxygenation index in patients with severe abdominal infection, which has a good clinical curative effect for postoperative severe abdominal infection .%目的：探讨药用炭片联合血液净化治疗对重症腹腔感染术后患者肾功能、炎性介质、氧合指数（ oxygenation index ，OI）及肠屏障功能的影响。方法选取河北工程大学附属医院诊治的重症腹腔感染患者65例，根据随机数字表法随机分为2组：对照组32例临床常规治疗；实验组33例，在对照组基础上联合应用药用炭片联合血液净化治疗，检测2组患者的肾脏功能、炎性介质、OI、肠屏障功能及疗效。结果治疗后，与对照组比较，实验组血肌酐（serum creatinine，Scr）、尿素氮（blood urea nitrogen，BUM）及血尿酸（uric acid，UA）等肾功能指标水平较低（P＜0．05）；实验组肿瘤坏死因子－α（tumor necrosis factor alpha，TNF－α）、白介素－6（interleukin－6，IL－6）、白介素－8（interleukin－8，IL－8）等炎性介质浓度水平较低（P＜0．05）；实验组氧合指数水平较高（P＜0．05）；实验组血浆二胺氧化酶（diamine oxidase，DAO）和内毒素脂多糖（lipopolysaccharide，LPS）等肠屏障功能指标水平较低（P＜0．05）；实验组总有效率较高（χ2＝3．91，P＜0．05）。结论药用炭片联合血液净化能有效改善患者肾脏功能，降低炎性介质水平，改善肠屏障功能，提高氧合指数水平，对严重腹腔感染患者有较好的临床疗效。