连续性血液滤过联合纳洛酮治疗PICU多器官功能障碍综合征的临床分析

Clinical analysis of continuous blood filtration combined with naloxone in treatment of PICU multiple organ dysfunction syndrome

目的探讨连续性血液滤过联合纳洛酮治疗儿科重症监护病房(pediatric intensive care unit,PICU)多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的治疗效果及应用价值。方法选择郑州市儿童医院治疗的多器官功能障碍综合征患者42例作为研究对象,采取随机数字表法分为观察组和对照组,每组各21例,对照组采用PICH常规治疗,观察组在对照组基础上联合连续性血液滤过和纳洛酮治疗,比较2组患者生命体征、肌酐、肌酸激酶及天冬氨酸转氨酶水平以及住院时间与血液滤过使用时间。结果观察组患者治疗后1 d和治疗后3 d在心率、氧合指数、肌酐、肌酸激酶以及天冬氨酸转氨酶各项指标改善情况均优于对照组同一时间节点(P<0.05)。观察组连续性血液滤过使用时间和住院时间均短于对照组(P<0.05)。结论采用连续性血液滤过联合纳洛酮治疗PICU中MODS疗效可靠,明显改善患者肾脏功能,缩短患者住院时间,清除患者血浆中的炎症介质因子。

Objective To investigate clinical effect of patients with PICU multiple organ dysfunction by continuous blood filtration combined with naloxone. Methods 42 patients with multiple organ function failure were selected and randomly divided into 2 groups. The control group were treated by PICU conventional therapy,the experiment group were treated by continuous blood filtration combined with Naloxone. Vital signs,creatinine,creatine kinase and aspartate aminotransferase levels,length of stay and blood filtration were compared after 1 day and 3 days treatment. Results Compared with control group,heart rate,oxidation index,creatinine and aspartate aminotransferase levels of the experiment group were lower( P < 0. 05). After 1 day and 3 days,compared with cnontrol group,length of stay and blood filtration of the experiment were lower( P < 0. 05). Conclusion Continuous blood filtration combined with naloxone in treatment of multiple organ dysfunction syndrome PICU is effective and reliable. It can significantly improve renal function,shorten the length of hospital stay,and remove inflammatory mediators in plasma of patients.