CRRT单用与联合血液灌流治疗多器官功能障碍综合征的效果比较

Clinical efficacy of hemoperfusion combined with CRRT and CRRT alone on treatment of multiple organ dysfunction syndrome

目的比较血液灌流联合连续性肾脏替代治疗(CRRT)与单用CRRT治疗多器官功能障碍综合征的临床疗效。方法选择2014年1月至2014年12月新疆兵团第六师医院和自治区人民医院收治的多器官功能障碍综合征患者200例,随机分为观察组和对照组,每组各100例。对照组给予CRRT治疗,观察组给予血液灌流联合CRRT治疗。对两组患者治疗前后的生命体征、血气参数及生化指标进行比较。结果 1治疗后观察组患者的收缩压、舒张压及心率均明显低于治疗前和对照组,具有显著性差异(P<0.05)。2治疗后观察组患者的pO2、pCO2及HCO3参数明显优于治疗前和对照组,具有显著性差异(P<0.05)。3治疗后观察组患者的Scr、BUN、K+、Na+及TNF-α生化指标明显低于治疗前和对照组,具有显著性差异(P<0.05)。结论血液灌流联合CRRT治疗多器官功能障碍综合征,可明显改善患者的生命体征、血气参数和生化指标,值得临床推广与应用。

Objective To compare the clinical efficacy of hemoperfusion combined with CRRT and CRRT alone in treatment of multiple organ dysfunction syndrome. Methods 200 patients with multiple organ dysfunction syndrome were randomly divided into observation group and control group, with 100 cases in each group. Control group was treated by CRRT, and observation group was treated by hemoperfusion combined CRRT. The vital signs, blood gas parameters and biochemical index of patients in two groups were compared. Results Systolic blood pressure, diastolic blood pressure and heart rate in observation group after treatment were significantly lower than that before treatment and control group. The difference was statistically significant （P〈0.05）. The pO2 , HCO3 and HCO3 in observation group after treatment were significantly better than that before treatment. The pCO2 in observation group after treatment were significantly lower than that before treatment and control group. The difference was statistically significant （P〈0.05）. The level of Scr, BUN, K＋ , Na＋ and TNF-α in observation group after treatment were significantly lower than that before treatment and control group. The difference was statistically significant （P〈0.05）. Conclusion Hemoperfusion combined with CRRT in the treatment of multiple organ dysfunction syndrome can improve vital signs, blood gas parameters and bio- chemical index.