连续性血液净化治疗严重脓毒症儿童的临床效果分析

Effect of continuous blood purification on clinical efficiency in children with severe sepsis

目的探讨连续性血液净化(CBP)治疗儿童严重脓毒症的临床效果。方法选择2019年1月至2020年6月收住重症监护病房(PICU)行CBP治疗的严重脓毒症患儿30例作为本次研究对象。观察按照CBP治疗前后及不同时间点(8、12、24和48 h组)的小儿危重症评分(PCIS)、pH、乳酸(Lac)、血压、氧合指数(PaO_(2)/FiO_(2))、尿素氮(BUN)、血肌酐(Scr)、血钠(Na^(+))、血钾(K^(+))、尿量等指标的变化情况。应用SPSS17.0统计软件进行数据分析。结果随着治疗时间的延长,患儿的PCIS评分逐渐增高(P<0.05);患儿血pH值、血压、PaO_(2)/FiO_(2)逐渐上升,Lac逐渐下降(P<0.05),CBP治疗48 h血pH、Lac、血压、PaO_(2)/FiO_(2)、BUN、Scr、血K^(+)可达正常参考值范围;尿量增加(P<0.05),但血Na^(+)无明显变化(P>0.05)。结论CBP可以有效改善严重脓毒症患儿的内环境及脏器功能,减轻疾病危重状态,临床效果明显。

Objective To explore the continuous blood purification(CBP)on clinical effectin children with severe sepsis.Methods Thirty children with severe sepsis for CBP treatment were enrolled this clinical study from January 2019 to June 2020.The PCIS,PH,Lac,blood pressure,PaO_(2)/FiO_(2),BUN,Scr,Na^(+),K^(+)and urine volume were recorded before and 8 h,12 h,24 h and 48 h after CBP treatment and the data was analyzed.Results With the extension of treatment,the PCIS score,PH,blood pressure,PaO_(2)/FiO_(2) were gradually increased,whilethe Lac were gradually decreased.After 48h of CBP treatment,the PH,Lac,blood pressure,PaO_(2)/FiO_(2) BUN,Scr and blood K^(+)could recovery to the normal reference range.Urine volume was increased(P<0.05),but there was no significant change in blood Na^(+)(P>0.05).Conclusion CBP can effectively improve the internal environment and viscera function of children with severe sepsis,and reduce the critical state of the disease.