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目的评价应用连续性静脉-静脉血液滤过(CVVH)联合血液灌流(HP)治疗全身炎症反应综合征(SIRS)伴急性肾衰竭的临床治疗效果。方法 30例SIRS伴急性肾衰竭患者,随机分为治疗组16例和对照组14例。治疗组给予CVVH+HP治疗,对照组给予单纯CVVH治疗。比较治疗前后各项临床及生化指标的变化情况[急性生理与慢性健康评分表(APACHEⅡ)、平均动脉压(MAP)、氧合指数(PaO2/FiO2)、白细胞介素-10(IL-10)]。结果治疗组患者在治疗后MAP、PaO2/FiO2较治疗前有显著提高,IL-10降低,与对照组相比差异有统计学意义(P<0.05)。结论 CVVH联合HP能有效降低SIRS患者炎症因子水平,改善患者的预后,无明显不良反应,可在临床进一步应用。
Objective To evaluate the clinical effect of continuous veno-venous hemofiltration (CVVH) and hemoperfusion (HP) on systemic inflammatory response syndrome (SIRS) with acute renal failure. Methods Thirty patients with SIRS and acute renal failure were randomly divided into treatment group (n = 16) and control group (n = 14). The treatment group was treated with CVVH + HP and the control group with CVVH alone. The changes of various clinical and biochemical indexes before and after treatment were compared (APACHEⅡ, MAP, PaO2 / FiO2, IL-10) ]. Results After treatment, the MAP, PaO2 / FiO2 and IL-10 in the treatment group were significantly higher than those before treatment (P <0.05). Conclusions CVVH combined with HP can effectively reduce the level of inflammatory cytokines in patients with SIRS and improve the prognosis of patients with no obvious adverse reactions and can be further applied clinically.