亚胺培南联合连续性血液净化治疗脓毒症致急性呼吸窘迫综合征的效果

Effect of imipenem combined with continuous blood purification in the treatment of acute respiratory distress syndrome caused by sepsis

目的 探讨亚胺培南联合连续性血液净化治疗脓毒症致急性呼吸窘迫综合征(ARDS)的临床价值。方法选取2018年1月至2021年12月收治的40例脓毒症致ARDS患者为研究对象,随机将其分为对照组与观察组,各20例。对照组实施连续性血液净化治疗,观察组在对照组基础上联合亚胺培南治疗。比较两组的治疗效果。结果 观察组的治疗总有效率高于对照组(P<0.05)。治疗后,观察组的CD4^(+)、CD4^(+)/CD8^(+)、自然杀伤(NK)细胞高于对照组,CD8^(+)、CD4^(+)CD25^(+)低于对照组(P<0.05)。治疗后,观察组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)、降钙素原(PCT)水平低于对照组,白细胞介素-10(IL-10)水平高于对照组(P<0.05)。治疗后,观察组的血氧分压(PaO2)、酸碱度(pH)、氧合指数高于对照组,二氧化碳分压(PaCO_(2))低于对照组(P<0.05)。结论 亚胺培南联合连续性血液净化治疗脓毒症致ARDS患者可有效缓解呼吸窘迫情况,改善血氧指标,抑制炎性物质,降低免疫压力。

Objective To investigate the clinical value of imipenem combined with continuous blood purification in the treatment of acute respiratory distress syndrome(ARDS)caused by sepsis.Methods A total of 40 patients with ARDS caused by sepsis admitted from January 2018 to December 2021 were selected as the research objects and randomly divided into control group and observation group,with 20 cases in each group.The control group was treated with continuous blood purification,and the observation group was treated with imipenem on the basis of the control group.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the CD4^(+),CD4^(+)/CD8^(+)and natural killer(NK)cell in the observation group were higher than those in the control group,while the CD8+and CD4^(+)CD25^(+)were lower than those in the control group(P<0.05).After treatment,the levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP)and procalcitonin(PCT)in the observation group were lower than those in the control group,and the level of interleukin-10(IL-10)was higher than that in the control group(P<0.05).After treatment,the partial pressure of blood oxygen(PaO_(2)),pondus hydrogenii(pH)and oxygenation index in the observation group were higher than those in the control group,and the partial pressure of carbon dioxide(PaCO_(2))was lower than that in the control group(P<0.05).Conclusion Imipenem combined with continuous blood purification in the treatment of ARDS patients caused by sepsis can effectively alleviate respiratory distress,improve blood oxygen indexes,inhibit inflammatory substances and reduce immune pressure.