连续性肾脏替代治疗急性呼吸窘迫综合征的临床疗效分析

Clinical Efficacy Analysis of Continuous Renal Replacement in the Treatment of Acute Respiratory Distress Syndrome

目的研究连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的临床疗效。方法方便选取莆田市第一医院2019年3月—2022年3月收治的69例ARDS患者作为研究对象,分为观察组(采取CRRT方式,35例)和对照组(常规治疗,34例)。对比两组不同时间段氧合指数、炎症因子水平、慢性健康状况评分Ⅱ(APACHEⅡ)和多器官损伤(MODS)评分、T细胞亚群水平、总有效率。结果观察组第1、3、7、14天氧合指数均高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组ARDS患者TNF-α、IL-6、CRP水平均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组APACHEⅡ评分和MODS评分均低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组T细胞亚群水平和对照组对比,差异有统计学意义(P<0.05)。观察组总有效率明显高于对照组,差异有统计学意义(P<0.05)。结论连续性肾脏替代治疗急性呼吸窘迫综合征效果显著,能够改善其免疫功能,减轻机体炎症反应。

Objective To investigate the clinical effect of continuous renal replacement therapy(CRRT)in the treatment of acute respiratory distress syndrome(ARDS).Methods A total of 69 ARDS patients admitted to the First Hospital of Putian City from March 2019 to March 2022 were selected conveniently as research objects,and divided into observation group(35 patients receiving CRRT mode)and control group(34 patients receiving conventional treatment).The oxygenation index,inflammatory factor levels,chronic health status scoreⅡ(APACHEⅡ)and multiple organ injury(MODS)scores,T cell subsets and total effective rate were compared between the two groups at different time periods.Results The oxygenation index in the observation group were higher than those in the control group at day 1,3,7 and 14,and the difference was statistically significant(P<0.05).After treatment,the levels of TNF-α,IL-6 and CRP in ARDS patients in observation group were lower than those in control group,and the difference was statistically significant(P<0.05).After treatment,APACHEⅡscores and MODS scores in the observation group were lower than those in the control group,and the difference was statistically significant(P<0.05).After treatment,the level of T cell subsets in the observation group was compared with that in the control group,the difference was statistically significant(P<0.05).The total effective rate of the observation group was significantly higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion Continuous renal replacement is effective in the treatment of acute respiratory distress syndrome,which can improve the immune function and reduce the inflammatory response.