连续性肾脏替代治疗对ICU脓毒血症合并急性呼吸窘迫综合征患者的疗效影响

摘要

Objective:To analyze the effect of continuous renal replacement in patients with septicopyemia and acute respiratory distress syndrome in ICU.Method:58 patients with septicopyemia and acute respiratory distress syndrome in the ICU of our hospital from January 2011 to December 2014 were selected as the research objects.They were divided into the control group and the research group according to different treatment methods. The control group was given symptomatic supportive treatment,such as conventional medicine to protect the kidney and maintain internal environment stability,the research group was given continuous renal replacement.The APACHE Ⅱ score,inflammatory indicators,death status,hospital stays and vital signs were compared between the two groups.Result:After treatment,the APACHE Ⅱ scores of the two groups were all lower than those before treatment and the APACHE Ⅱ score of the research group was lower than that of the control group,the differences were statistically significant(P<0.05).After treatment,the levels of WBC,CRP and PCT in the research group were all lower than those in the control group and before treatment,the differences were statistically significant (P<0.05).The difference in the death rate of the two groups was not statistically significant(P>0.05).The average ICU hospital stays of the research group was shorter than that of the control group,the body temperature,heart rate,breathing and mean arterial pressure of the research group were all better than those of the control group,the differences were all statistically significant(P<0.05).Conclusion:The effect of continuous renal replacement in patients with septicopyemia and acute respiratory distress syndrome in ICU is better,patients’ immune function recovers faster.It is worthy of clinical promotion and application.%目的：分析连续性肾脏替代治疗对ICU脓毒血症合并急性呼吸窘迫综合征患者的疗效。方法：选取2011年1月-2014年12月于本院ICU住院治疗的脓毒血症合并急性呼吸窘迫综合征患者58例作为研究对象，根据治疗方式的不同分为对照组与研究组。对照组给予常规药物护肾、维持内环境稳定等对症支持治疗，研究组采用连续肾脏替代治疗，比较两组APACHE Ⅱ评分、炎性指标、死亡情况、住院时间及生命体征。结果：两组治疗后APACHE Ⅱ评分均低于治疗前，且研究组治疗后APACHE Ⅱ评分低于对照组，比较差异均有统计学意义（P<0.05）；研究组治疗后WBC、CRP及PCT水平均低于治疗前及对照组，比较差异均有统计学意义（P<0.05）；两组死亡率比较，差异无统计学意义（P>0.05）；研究组平均ICU住院时间明显短于对照组，体温、心率、呼吸及平均动脉压均明显优于对照组，比较差异均有统计学意义（P<0.05）。结论：连续性肾脏替代治疗对ICU脓毒血症合并急性呼吸窘迫综合征患者的疗效较好，患者免疫功能恢复更快，值得临床推广应用。