不同容量连续性肾脏替代治疗严重腹腔感染对比研究

The Different Capacity of Continuous Renal Replacement Comparative Study on Treatment of Severe Abdominal Cavity Infection

目的研究在治疗严重腹腔感染时不同血液滤过量连续性肾脏替代治疗的对比情况。方法该研究选取2012年1月—2013年12月间该院收治的60例患者为研究对象,将60例患者平均分成两组,分别对其采取常规血液滤过量,作为常规容量组;大容量持续连续性肾脏替代治疗,作为大容量组。分别治疗前后4 h、12 h、24 h、36 h、48 h、72 h 6个时间段血浆肿瘤坏死因子-α（TNF-α）、白介素-6（IL-6）水平及降钙素原（PCT）水平,并统计其ICU入住时间、机械通气时间、日均医疗费用。结果施用大量容量持续连续性肾脏替代治疗的小组,其治疗后4~48 h之间TNF-α、IL-6水平下降明显,之后没有明显下降,而PCT则在4~72 h一直处于下降状态。经过统计后,大容量小组ICU入住时间、机械通气时间均短于常规容量小组,而日均医疗费用两组之间无明显差距。结论 在费用基本相同的情况下,利用较大血液滤过量连续性肾脏替代法可以有效缓解腹腔感染症状,值得在临床实践中进行推广。

Objective Comparison study of different in the treatment of severe abdominal infection hemofiltration quantity in con-tinuous renal replacement therapy. Methods 40 patients were divided into two groups.Respectively to take excessive, large capaci-ty of conventional filter blood continuously continuous renal replacement therapy.Respectively before and after treatment 4 h ,12 h, 24 h, 36 h, 48 h, 72 h six time of plasma tumor necrosis factor alpha（TNF- α）, interleukin-6（IL-6） and the of procalcitonin （PCT） level.And statistics of their ICU stay, mechanical ventilation time, average medical expenses. Result Large capacity continuous application of continuous renal replacement therapy group.The after treatment between 4~48 h TNF-α, IL-6 levels decreased significantly, after no obvious decline.PCT in 4~72 h has been in a state of decline.After statistics, large capacity ICU group check-in time, me-chanical ventilation time were shorter than the normal capacity of group, and the daily average medical expenses between the two groups had no significant difference. Conclusion In the same basic cost, using large volume hemofiltration continuous renal replacement method can be effective in the treatment of abdominal infection symptoms, and it is worthy to popularize in clinical practice.