白蛋白联合连续肾脏替代疗法治疗毛细血管渗漏综合征的研究

The study of albumin combination with continuous renal replacement therapy to treat capillary leak syndrome

目的探讨白蛋白联合连续肾脏替代疗法(CRRT)治疗毛细血管渗漏综合征(CLS)的临床疗效。方法采用前瞻性研究选取近年收治的156例CLS患者,随机分为观察组和对照组各78例,对照组予以常规对症处理,观察组予以白蛋白、CRRT联合治疗,观察对比两组存活率、肝肾功能、病情严重程度及预后、平均动脉压(MBP)、动脉血氧分压(PaO_2)、24 h尿量、全身水肿改善时间、肺水肿改善时间及入住ICU时间。结果观察组存活率为75.6%,高于对照组的51.3%(P<0.05)。观察组BUN、SCr均低于对照组(P<0.05);观察组的APACHEⅡ评分、SAPSⅡ评分和MODS评分均低于对照组(P<0.05);观察组全身水肿、肺水肿改善时间及入住ICU时间均短于对照组(P<0.05);观察组MBP、PaO_2及24 h尿量均高于对照组(P<0.05)。结论对CLS患者开展白蛋白联合CRR治疗,可取得满意的治疗效果,有助于促进机体血液循环运行正常,并可改善肾功能、减轻水肿,进而改善病情及临床预后。

Objective To observe the clinical efficacy of albumin combination with continuous renal replacement therapy（ CRRT） to treat capillary leak syndrome. Methods 156 cases of CLS patients were randomly divided into observation group and control group,with 78 cases in each group. The control group was given routine symptomatic treatment,the observation group received albumin with CRRT. The survival rate and the severity of liver and kidney function,and prognosis,mean arterial pressure（ MBP） arterial oxygen pressure（ PaO2）,24 h urine volume,systemic edema improvement time,pulmonary edema improved time and ICU stay time in the two groups were observed and compared. Results Observation group survival rate 75. 6% was higher than that of control group 51. 3%（ P〈0. 05）. BUN,SCr in observation group were lower than that of control group（ P〈0. 05）. APACHE Ⅱ score,SAPS Ⅱ score and MODS score of observation group were lower than those of control group（ P〈0. 05）. MBP,PaO2 and 24 h urine of observation were higher than those of control group（ P〈0. 05）. Anasarca,pulmonary edema,improve time and ICU admission time of observation group was shorter than those of the control group（ P〈0. 05）. Conclusion Albumin with CRRT for the treatment of CLS can obtain satisfactory therapeutic effect,and help to promote blood circulation running normally,and can improve renal function,relieve edema,improve the condition and clinical prognosis.