低温高容量血液滤过对重症颅脑损伤后生命体征、炎性因子水平和预后的影响

摘要

Objective To observe the influence of low-temperature high volume hemofiltration on vital signs,inflammatory factor level and prognosis of patients with severe craniocerebral injury. Methods 98 patients with severe craniocerebral injury were divided into two groups randomly. The control group(n=49)received conventional treatment combined with decompressive craniectomy,based on which the observation group(n=49)was treated with low-temperature high volume hemofiltration. The indicators of vital signs,inflammatory factor level and prognosis of two groups were compared. Results The vital sign indicators of the observation group improved more evidently compared with that of the control group( P ﹤0. 05). TNF-α,IL-6 and IL-8 of the observation group reduced more evidently compared with that of the control group( P ﹤0. 05),and the descend range was better than those of the control group( P ﹤0. 05). There were 13 cases in the control group(26. 5%)who abandoned the research because of hypernatremia and acute renal failure needing blood purification,and there was no patients abandoned in the observation group. Conclusion Low-temperature high volume hemofiltration can improve the vital signs of patients with severe craniocerebral in-jury,inhibit inflammatory response and can improve prognosis.%目的：观察低温高容量血液滤过对重症颅脑损伤后相关生命体征、炎性因子水平和预后的影响。方法将98例重症颅脑损伤患者随机分为两组，对照组（n=49）给予常规治疗加行去骨瓣减压术，观察组（n=49）在对照组基础上行低温高容量血液滤过治疗；比较两组患者的各项生命体征检测指标、炎性因子水平和预后。结果观察组治疗后的生命体征指标较对照组改善明显（ P ﹤0.05）；观察组治疗后的TNF-α、IL-6、IL-8较治疗前显著下降（ P ﹤0.05），且下降幅度优于对照组（ P ﹤0.05）；对照组13例（26.5%）因出现高钠血症、急性肾衰竭需血液净化而退出研究，观察组未出现此情况。结论低温高容量血液滤过利于改善重症颅脑损伤患者的生命体征，抑制炎症反应，改善预后。