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目的:探讨连续性血浆滤过吸附对严重感染合并多脏器功能障碍综合征(MODS)患者炎症因子水平的影响。方法:研究对象选取我院2013年3月-2016年3月收治严重感染合并MODS患者共160例,以随机数字表法分为对照组(80例)和观察组(80例),患者均先给予高容量血液滤过(HVHF)治疗,观察组加用连续性血浆滤过吸附辅助治疗,比较两组患者治疗前后平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)、碳酸氢根(HCO_3~-)、肌酐(Scr)、总胆红素(TBi L)、急性生理与慢性健康II(APACHE Ⅱ)评分、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)及白介素6(IL-6)水平。结果:两组治疗后MAP、Scr、TBi L、TNF-α、IL-6、hs-CRP及APACHE Ⅱ评分均有所降低,而HR、SpO_2、HCO_3~-水平均上升,且观察组以上各指标改善更明显,差异均有统计学意义(P<0.05)。结论:连续性血浆滤过吸附辅助治疗严重感染合并MODS可有效稳定生命体征,改善生化指标,延缓病情进展,并有助于降低机体炎症反应水平。
Objective: To investigate the effect of continuous plasma filtration on inflammatory cytokines in severe infection complicated with multiple organ dysfunction syndrome (MODS). Methods: A total of 160 severe MODS patients admitted to our hospital from March 2013 to March 2016 were selected and randomly divided into control group (80 cases) and observation group (80 cases) The patients in the observation group were treated with continuous plasma filtration and adsorption adjuvant therapy. The mean arterial pressure (MAP), heart rate (HR), blood oxygen saturation (SpO2) The levels of HCO3, Scr, APACHE Ⅱ, TNF-α, high sensitivity C-reactive protein (hs-CRP) and interleukin-6 (IL-6) levels. Results: After treatment, the levels of MAP, Scr, TBi L, TNF-α, IL-6, hs-CRP and APACHE Ⅱ decreased, while the levels of HR, SpO 2 and HCO 3 - Indicators improved more obviously, the difference was statistically significant (P <0.05). Conclusion: Continuous plasma filtration adsorption adjuvant treatment of MODS with severe infection can effectively stabilize vital signs, improve biochemical indicators, delay the progression of the disease, and help to reduce the level of inflammatory reaction.