连续性肾脏替代治疗在腹腔脓毒症合并急性呼吸窘迫综合征中的应用

Clinical application of continuous renal replacement therapy to the patients with peritoneal sepsis and acute respiratory distress syndrome

目的观察连续性。肾脏替代治疗（CRRT）对腹腔脓毒症合并急性呼吸窘迫综合征（ARDS）患者的治疗效果。方法对本院普通外科于2009—01～2011—12应用CRRT救治腹腔脓毒症合并ARDS患者12例进行回顾分析。结果12例腹腔脓毒症患者CRRT后血浆炎症因子TNF-α、IL-6、IL-8浓度呈持续性下降趋势，而作为判断氧合能力的常用指标PaO2、PaO2／FiO2明显升高，气道峰压明显下降，与治疗前比较差异有统计学意义。结论CRRT能有效降低血清TNF-α、IL-6、IL-8等炎症因子水平，减轻全身炎症反应，改善脓毒症合并ARDS患者的预后。

Objective To study curative effect of continuous renal replacement therapy （CRRT） in peritoneal sepsis patients with acute respiratory distress syndrome （ARDS）. Methods CRRT treatment in 12 cases of peritoneal sepsis patients with ARDS was retrospectively analyzed in our general surgery from Jan. 2009 to Dec. 2011. Results The patients＇average levels of plasma TNF - α, IL- 6, IL- 8 declined significantly, and the index of oxygenation PaO2, PaO2/FiO2 improved significantly, and the airway peak pressure （Ppeak） dropped significantly 72 hours after CRRT. Conclusion CRRT can effectively lower the serum levels of cytokine TNF - α, IL - 6, IL - 8 and reduce the general inflammatory response in sepsis patients with ARDS, and improve their prognosis.