| 陈亚强,刘巧艳,王子正,邵泽斌,房 阁.持续性血液滤过联合高流量吸氧治疗重症急性呼吸综合征的疗效及对血清炎症因子水平的影响[J].,2019,19(22):4303-4307 |
| 持续性血液滤过联合高流量吸氧治疗重症急性呼吸综合征的疗效及对血清炎症因子水平的影响 |
| Curative Efficacy of Continuous Blood Filtration Combined with High Flow Oxygen Uptake in the Treatment of Severe Acute Respiratory Syndrome and Its Effects on the Serum Inflammatory Factors Levels |
| 投稿时间：2019-04-08 修订日期：2019-04-30 |
| DOI：10.13241/j.cnki.pmb.2019.22.022 |
| 中文关键词: 持续性血液滤过 高流量吸氧 重症急性呼吸综合征 炎症因子 |
| 英文关键词: Continuous blood filtration High flow oxygen Severe acute respiratory syndrome Inflammatory cytokines |
| 基金项目:陕西省自然科学基金项目(20131067) |
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| 中文摘要: |
| 摘要 目的：探讨持续性血液滤过联合高流量吸氧治疗重症急性呼吸综合征的疗效及对血清炎症因子水平的影响。方法：选择2013年2月至2016年2月我院接诊的60例重症急性呼吸综合征患者，通过随机数表法将其分为观察组(n=30)和对照组(n=30)。观察组采用持续性血液滤过联合高流量吸氧进行治疗，对照组采用持续性血液滤过进行治疗。比较两组临床疗效、治疗前后动脉血氧分压(PaO2)、动脉血二氧化碳分压 (PaCO2)、氧合指数、氢离子浓度指数(pH)值、呼吸频率(RR)、心率(HR)、血清C反应蛋白(CRP)、白介素6(IL-6)、白介素8(IL-8)、肿瘤坏死因子α(TNF-α)水平的变化及不良反应的发生情况。结果：治疗后，观察组有效率为76.67%，显著高于对照组(50.00%，P<0.05)。两组治疗后PaO2、PaCO2、氧合指数、pH值、RR、HR均较治疗前明显改善，观察组患者PaO2、氧合指数明显高于对照组，PaCO2、pH值、RR、HR、血清CRP、IL-6、IL-8及TNF-α水平均显著低于对照组(P<0.05)。治疗期间，观察组患者不良反应总发生率(10.00%)显著低于对照组(36.67%，P<0.05)；观察组死亡1例(3.33%)，对照组死亡6例(20.00%)，观察组病死率显著低于对照组(P<0.05)。结论：持续性血液滤过联合高流量吸氧治疗重症急性呼吸综合征患者的临床疗效及安全性明显优于单用持续性血液滤过治疗，可能与其更有效减轻炎症反应有关。 |
| 英文摘要: |
| ABSTRACT Objective: To study the curative efficacy of continuous blood filtration combined with high flow oxygen uptake in the treatment of severe acute respiratory syndrome and its effects on the inflammatory factors. Methods: 60 cases of patients with severe acute respiratory syndrome admitted to our hospital from February 2013 to February 2016 were selected and divided into the observation group (n=30) and the control group (n=30) by random number table method. The observation group was treated with continuous hemofiltration combined with high flow oxygen, while the control group was treated with continuous hemofiltration. Clinical efficacy, arterial partial oxygen pressure (PaO2), arterial partial carbon dioxide pressure (PaCO2), oxygenation index, hydrogen ion concentration index (pH), respiratory rate (RR), heart rate (HR), serum c-reactive protein (CRP), interleukin-6 (il-6), interleukin-8 (il-8), and tumor necrosis factor (TNF-α) were compared between the two groups. Results: After treatment, the effective rate of observation group was 76.67%, which was significantly higher than that of the control group (50.00%, P<0.05). After treatment, the PaO2, PaCO2, oxygenation index, pH value, RR and HR in both groups were significantly improved compared with those before treatment. The PaO2 and oxygenation index in the observation group were significantly higher than those in the control group, and the levels of PaCO2, pH value, RR, HR, serum CRP, IL-6, IL-8 and TNF-α were significantly lower than those in the control group (P<0.05). During the treatment, the total incidence of adverse reactions in the observation group (10.00%) was significantly lower than that in the control group (36.67%, P<0.05). One case died in the observation group (3.33%), and six cases died in the control group (20.00%). The fatality rate of the observation group was significantly lower than that of the control group (P<0.05). Conclusion: The clinical efficacy and safety of continuous hemofiltration combined with high-flow oxygen inhalation in the treatment of patients with severe acute respiratory syndrome are significantly better than that of continuous hemofiltration alone, which may be related to the effective reduction of inflammatory reactions. |
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