连续性血液净化治疗多器官功能障碍综合征患者的临床效果研究

Study on clinical effect of continuous blood purification on patients with multiple-organ dysfunction syndrome

目的 探讨连续性血液净化(CBP)治疗多器官功能障碍综合征的临床效果及对患者血清炎性因子的影响。方法 60例多器官功能障碍综合征患者,采用随机数字表法分为对照组和研究组,每组30例。对照组采用常规治疗方案诊治,研究组在对照组的基础上采用连续性血液净化治疗。比较两组治疗效果、治疗前后的多器官功能障碍综合征评分、血液流变学指标、炎症因子[C反应蛋白(CRP)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平。结果 研究组治疗总有效率为97%,高于对照组的80%,差异有统计学意义(P<0.05)。治疗后,研究组多器官功能障碍综合征评分(8.05±2.62)分低于对照组的(16.51±3.90)分,差异有统计学意义(P<0.05)。治疗后,研究组血小板粘附率、血浆比粘度、全血高切粘度分别为(30.08±10.97)%、(1.09±0.01)、(3.98±0.03)mPa·s,均低于对照组的(57.62±15.28)%、(1.52±0.09)、(5.88±0.14)mPa·s,差异有统计学意义(P<0.05)。治疗后,研究组CRP、IL-10、IL-6、TNF-α分别为(80.02±10.97)mg/L、(51.97±6.93)ng/ml、(101.03±10.28)ng/ml、(64.55±8.57)pg/ml,均低于对照组的(104.62±15.28)mg/L、(90.23±10.96)ng/ml、(124.32±8.09)ng/ml、(90.02±12.94)pg/ml,差异有统计学意义(P<0.05)。结论 多器官功能障碍综合征患者经连续性血液净化治疗的临床效果显著,患者的生命体征稳定,体内炎性水平得到改善,生活质量提高,值得临床推广使用。

Objective To discuss the clinical effect of continuous blood purification(CBP)on patients with multiple-organ dysfunction syndrome and its influence on serum inflammatory factors.Methods A total of 60 patients with multiple-organ dysfunction syndrome were divided into a control group and a study group according to random numerical table,with 30 cases in each group.The control group was treated with conventional regimen,and the study group was treated with continuous blood purification based on the control group.Both groups were compared in terms of therapeutic effect,multiple-organ dysfunction syndrome scores,hemorheology indexes,inflammatory factors[C-reactive protein(CRP),interleukin-10(IL-10),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)]levels before and after treatment.Results The total effective rate in the study group was 97%,which was higher than that of 80%in the control group,and the difference was statistically significant(P<0.05).After treatment,the score of multiple-organ dysfunction syndrome in the study group was(8.05±2.62)points,which were lower than that of(16.51±3.90)points in the control group,and the differences were statistically significant(P<0.05).After treatment,the platelet adhesion rate,plasma viscosity and whole-blood high-shear viscosity were(30.08±10.97)%,(1.09±0.01)and(3.98±0.03)mPa·s in the study group,which were lower than those of(57.62±15.28)%,(1.52±0.09)and(5.88±0.14)mPa·s in the control group,and the difference were statistically significant(P<0.05).After treatment,CRP,IL-10,IL-6 and TNF-αwere(80.02±10.97)mg/L,(51.97±6.93)ng/ml,(101.03±10.28)ng/ml and(64.55±8.57)pg/ml in the study group,which were lower than those of(104.62±15.28)mg/L,(90.23±10.96)ng/ml,(124.32±8.09)ng/ml and(90.02±12.94)pg/ml in the control group,and the differences were statistically significant(P<0.05).Conclusion The clinical effect of continuous blood purification in patients with multiple-organ dysfunction syndrome is remarkable,and can stable the vital signs of patients,improve the inflammatory level,and improve the quality of life of patients,which is worthy of clinical popularization.