早期持续血液净化在严重脓毒症合并急性呼吸窘迫综合征患者治疗中的应用

Application of Early Continuous Blood Purification in Treating Severe Sepsis with ARDS

目的对比早期和非早期持续血液净化(CBP)在严重脓毒症合并急性呼吸窘迫综合征(ARDS)患者治疗的应用效果。方法选取黔南州人民医院于2015—2016年重症加强护理病房(ICU)收治60例严重脓毒症合并ARDS患者作为研究对象,根据患者入ICU后行CBP时间分为早期组(行CBP时间<12 h)32例和非早期组(行CBP时间≥12 h)28例,分别于透析1 d和7 d时,测定和比较两组患者血清降钙素原(PCT)、CRP表达,记录患者ICU治疗时间、机械通气时间、有创通气时间、呼吸(BR)及血气分析指标。结果透析7d后,两组患者PCT和CRP显著优于透析1 d(P<0.05),早期组患者PCT和CRP显著优于非早期患者(P<0.05),治疗期间,早期组患者ICU治疗时间、机械通气时间及有创通气时间均显著低于非早期组患者(P<0.05),透析后,两组患者BR血气分析指标均较透析前显著改善(P<0.05),早期组患者BR血气分析指标显著优秀与非早期患者(P<0.05)。结论早期CBP能有效改善严重脓毒症合并ARDS患者预后,改善其呼吸功能障碍,值得临床推广。

Objective To compare the efficacy of early and non early continuous blood purification(CBP)in treating severe sepsis complicated with ARDS.Methods 60 cases of severe sepsis complicated with acute respiratory distress syndrome(ARDS)received in Duyun People's Hospital ICU from January 2015 to December 2016 were selected as the research object.They were divided into early stage group(CBP<12h time,32 cases)and the CBP group(non early stage time is no less than 12h,28 cases).Serum PCT,the expression of CRP treatment time,treatment time in ICU,mechanical ventilation time,ventilation time,BR and blood gas analysis index were determinated and recorded 1 d and 7 d respectively in dialysis.Results PCT and CRP of dialysis patients in two groups after 7d were significantly better than those after 1 d(P<0.05).Patients with early PCT and CRP were significantly better than those in non early patients(P<0.05).Early treatment time,mechanical ventilation time and ventilation time were significantly lower than those of the early group(P<0.05).BR blood gas analysis index were significantly improved after dialysis in both groups(P<0.05).Early BR blood gas analysis index in early patients were excellent than non early patients(P<0.05).Conclusion Early CBP can effectively improve the prognosis of patients with severe sepsis complicated with ARDS and improve their respiratory dysfunction,which is worthy of clinical promotion.