早期连续床旁血液净化治疗重度颅脑损伤的作用研究

Effect of Early Continuous Bedside Blood Purification on Severe Craniocerebral Injury

目的探究早期连续床旁血液净化治疗重度颅脑损伤的临床效果。方法选取本院2016年5月—2019年2月收治的重症颅脑损伤患者60例,采用摸球法分为A组和B组,各30例。2组患者均接受传统治疗,A组另辅以早期连续床旁血液净化治疗。治疗后观察治疗效果,包括存活率、病死率、血清肿瘤坏死因子、白细胞介素-6、动脉血乳酸水平、尿素氮、血肌酐、血钾、血钠及治疗前后格拉斯哥昏迷评分。结果A组存活率(86.67%),高于B组的(60.00%),病死率(13.33%),低于B组的(40.00%),差异有统计学意义(P<0.05)。A组血清肿瘤坏死因子、白细胞介素-6、动脉血乳酸水平低于B组,差异有统计学意义(P<0.05)。A组尿素氮、血肌酐、血钾、血钠均低于B组,差异有统计学意义(P<0.05)。治疗后,A组格拉斯哥昏迷评分低于B组和同组治疗前,差异有统计学意义(P<0.05)。结论早期连续床旁血液净化治疗重度颅脑损伤的作用显著,可改善其水电解质平衡及肾脏功能,抑制患者病情进展来确保其健康,具有较高临床推广价值。

Objective To explore the clinical effect of early continuous bedside blood purification in the treatment of severe craniocerebral injury.Methods 60 cases of patients with severe craniocerebral injury admitted to our hospital from May 2016 to February 2019 were selected,and 30 cases were divided into group A and group B by touch ball method.Patients in both groups received traditional treatment,and group A was supplemented by early continuous bedside blood purification.Outcomes were observed after treatment,including survival,mortality,serum tumor necrosis factor,interleukin-6,arterial blood lactic acid level,urea nitrogen,serum creatinine,potassium,sodium,and Glasgow coma score before and after treatment.Results The survival rate of group A(86.67%)was higher than that of group B(60.00%),and the fatality rate of group B(13.33%)was lower than that of group B(40.00%).The comparison was statistically significant(P<0.05).Serum levels of tumor necrosis factor,interleukin-6 and arterial blood lactic acid in group A were lower than those in group B,and the comparison was statistically significant(P<0.05).Urea nitrogen,serum creatinine,potassium and sodium in group A were all lower than those in group B,with statistically significant differences(P<0.05).After treatment,the Glasgow coma score of group A was lower than that of group B and the same group before treatment,and the comparison was statistically significant(P<0.05).Conclusion Early continuous bedside blood purification has a significant effect on the treatment of severe craniocerebral injury,which can improve the balance of water and electrolytes and renal function,and inhibit the disease progression of patients to ensure their health.