重症肺炎集束化治疗中早期连续性肾脏替代治疗的应用研究

Application Effect of Early Continuous Renal Replacement Therapy in Cluster Therapy for Severe Pneumonia

目的分析早期连续性肾脏替代治疗(CRRT)应用在重症肺炎(SP)集束化治疗中的临床效果。方法选择2014年1月~2018年12月郑州大学附属肿瘤医院收治的60例SP患者进行分组研究,采取随机双盲法分为两组,各30例。对照组以常规集束化治疗,观察组则加用早期CRRP治疗。评价两组疗效,测定治疗前、治疗1周时血氧饱和度(SaO2)、动脉血pH值、血浆降钙素原(PCT)、血清白介素-6(IL-6),并比较。结果观察组总有效率86.67%高于对照组66.67%(P <0.05);两组治疗前SaO2、动脉血pH值、血浆PCT、血清IL-6对比无显著差异(P>0.05),治疗1周时组间动脉血pH值无显著差异(P> 0.05),但观察组SaO2显著高于对照组(P <0.05),而血浆PCT、血清IL-6显著低于对照组(P <0.05)。结论 SP集束化治疗中应用早期CRRT治疗,相比常规集束化治疗可以更好地改善患者的SaO2、血浆PCT、血清IL-6等指标,而且可以明显提高预后,值得临床应用。

Objective To analyze the clinical effect of early continuous renal replacement therapy(CRRT)in the cluster therapy of severe pneumonia(SP).Methods 60 cases of SP patients admitted to our hospital from January 2014 to December 2018 were selected and divided into two groups with 30 cases in each group by random double blind method.The control group received conventional cluster therapy,while the observation group received early CRRP therapy.The therapeutic effects of the two groups were evaluated.Blood oxygen saturation(SaO2),arterial blood pH,plasma procalcitonin(PCT),and serum interleukin-6(IL-6)were measured and compared before and 1 week after treatment.Results The total effective rate in the observation group was 86.67%,higher than that in the control group(P<0.05).Before treatment,there was no significant difference in SaO2,arterial blood pH,plasma PCT and serum IL-6 between the two groups(P>0.05).After one week of treatment,there was no significant difference in arterial blood pH between the two groups(P>0.05),but SaO2 in the observation group was significantly higher than that in the control group(P<0.05),while plasma PCT and serum IL-6 were significantly lower than that in the control group(P<0.05).Conclusion The application of early CRRT in SP cluster therapy can better improve SaO2,plasma PCT,serum IL-6 and other indicators of patients than conventional cluster therapy,and can significantly improve the prognosis,which is worthy of clinical application.