血液净化在小儿脓毒症治疗中的应用效果

Effect of blood purification in the treatment of paediatric pyemia

目的观察血液净化联合常规治疗在小儿脓毒症治疗中的应用效果。方法选取2019年12月—2021年5月宁夏医科大学总医院儿童重症监护室(PICU)收治的小儿脓毒症患儿100例,采用随机数字表法分为观察组和对照组,各50例。对照组在常规治疗基础上予乌司他丁治疗,观察组在对照组基础联合血液净化治疗,2组均治疗7 d。比较2组患儿机械通气时间、PICU入住时间,以及治疗前后血清降钙素原、超敏C反应蛋白、乳酸水平、序贯器官衰竭(SOFA)评分、Treg/Th17。结果观察组患儿的机械通气时间、PICU入住时间明显短于对照组(P<0.05);观察组患儿治疗后的血清降钙素原、超敏C反应蛋白、乳酸水平、SOFA评分均低于对照组(P<0.05);观察组患儿治疗后的Treg/Th17均高于对照组(P<0.05)。结论血液净化与乌司他丁联合可增强小儿脓毒症患儿的疗效,促进炎性介质的清除,缓解患儿的器官损伤,值得临床推广。

Objective To observe the effect of blood purification combined with routine treatment in the treatment of paediatric pyemia.Methods From December 2019 to May 2021,100 children with pyemia were selected from PICU of General Hospital of Ningxia Medical University.The patients were divided into observation group and control group with 50 cases each by random number table.The control group was treated with ulinastatin for injection on the basis of routine treatment,while the observation group was treated with blood purification on the basis of the control group.Both groups were treated for 7 days.The mechanical ventilation time and PICU occupancy time of the two groups were compared.Serum procalcitonin,hs-CRP,blood lactic acid level,SOFA score,Treg/Th17 were compared before and after treatment.Results The mechanical ventilation time and PICU occupancy time of children in the observation group were significantly shorter than those in the control group(P<0.05).After treatment,the levels of serum procalcitonin,hs-CRP,blood lactic acid and SOFA score in the observation group were lower than those in the control group(P<0.05).After treatment,Treg/Th17 in the observation group was higher than that in the control group(P<0.05).Conclusion The combined treatment of blood purification and ulinastatin can enhance the therapeutic effect of paediatric pyemia,promote the removal of inflammatory mediators,and alleviate the organ damage of children,which is worthy of clinical promotion.