白蛋白联合连续肾脏替代疗法治疗毛细血管渗漏综合征研究

Albumin combined with continuous renal replacement therapy in the treatment of capillary leak syndrome

目的探究白蛋白联合连续肾脏替代法治疗毛细血管渗漏综合征的临床效果。方法选取在广西科技大学第一附属医院确诊为毛细血管渗漏综合征的患者81例为研究对象,随机分成治疗组与对照组。治疗组给予人血白蛋白注射液联合连续肾脏替代疗法治疗,对照组给予羟乙基淀粉氯化钠注射液治疗,对比两组患者的治疗效果。结果治疗组好转率69.23%,对照组好转率52.38%;治疗组病死率23.08%,对照组病死率30.95%;治疗组平均动脉压和动脉血氧分压分别为(92.97±14.92)mm Hg和(213.72±93.07)mm Hg,对照组为(85.17±12.88)mm Hg和(194.30±87.42)mm Hg;治疗组肺水肿改善时间(6.27±1.23)h、全身水肿改善时间(19.84±2.37)h,对照组肺水肿改善时间(8.72±0.75)h、全身水肿改善时间(22.94±2.62)h;以上各项指标两组比较,差异均有统计学意义(均P<0.05)。治疗1个月后,治疗组24 h尿量(2 101.92±861.91)ml,对照组24 h尿量(1 673.25±1 162.94)ml;治疗组APACHEⅡ评分(11.39±6.03)分,对照组APACHEⅡ评分(20.07±10.08)分;以上指标两组比较,差异均有统计学意义(均P<0.05)。结论白蛋白联合连续肾脏替代疗法能有效改善毛细血管渗透综合征的临床治疗效果,提升好转率,降低病死率,改善患者慢性健康情况及预后,值得在临床治疗中得到进一步的研究、推广与应用。

Objective To investigate the clinical effect of albumin combined with continuous renal replacement therapy in the treatment of capillary leak syndrome.Methods 81 patients with capillary leak syndrome diagnosed in our hospital were randomly divided into observation group and control group.The patients in the observation group were treated with human serum albumin injection and continuous renal replacement therapy.The control group was treated with hydroxyethyl starch and sodium chloride injection,and the therapeutic effect of the two groups was compared.Results The improvement rate of the treatment group was 69.23%,the improvement rate of the control group was 52.38%,the data comparison results(P<0.05) were statistically significant.The mortality rate of the treatment group was 23.08%,the mortality rate of the control group was 30.95%,the data comparison result(P<0.05) was statistically significant.The mean arterial pressure and arterial blood pressure were(92.97±14.92) mm Hg and(213.72±93.07) mm Hg in the treatment group,(85.17±12.88) mm Hg and(194.30±87.42) mm Hg in the control group,mean arterial pressure and arterial blood in the treatment group oxygen partial pressure was significantly higher than the control group,the difference was statistically significant(P<0.05).The improvement time of pulmonary edema in the study group was(6.27±1.23) h,and the improvement time of systemic edema was(19.84±2.37) h.The improvement time of pulmonary edema in the control group was(8.72±0.75) h,and the improvement time of systemic edema was(22.94±2.62) h.The improvement time of pulmonary edema and the improvement time of systemic edema in the treatment group were lower thanthose in the control group.The results were statistically significant(P<0.05).After one month of treatment,the urine output in the treatment group was(2 101.92±861.91) ml for 24 hours and 24 hours in the control group(1 673.25±1 162.94) ml.The 24-hour urine output of the treatment group was significantly higher than the control group,the results for the difference was statistically significant(P<0.05).APACHE Ⅱ score was 11.39±6.03 in the treatment group and APACHE Ⅱ in the control group 20.07±10.08.APACHE Ⅱ score in the treatment group was significantly lower than that in the control group.The difference was statistically significant(P<0.05).Conclusions Albumin combined with continuous renal replacement therapy can effectively improve the clinical treatment of CAPS,improve the patient's recovery rate,reduce the mortality rate of patients,improve the chronic health condition and prognosis of patients,and deserve further clinical treatment.It is worthy of further research,popularization and application in clinical treatment.