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目的:探讨在连续血液净化中更换滤器的时间对严重腹腔感染治疗效果的影响。方法:选择严重腹腔感染患者100例,按随机数字表法将其分为观察组和对照组,每组50例。患者均采用静脉-静脉血液滤过治疗,观察组每24 h更换滤器,对照组则待血凝时更换滤器。观察两组患者治疗前后TNF-α、IL-10、氧合指数(OI)、血浆二胺氧化酶(DAO)及内毒素脂多糖(LPS)的变化。结果:两组患者治疗前后TNF-a、IL-10水平比较,观察组患者下降程度明显大于对照组,差异有统计学意义(P<0.05)。两组患者治疗前后OI、DAO及LPS水平比较,差异有统计学意义(P<0.05);随着治疗的进行,观察组患者OI升高程度明显大于对照组,DAO、LPS降低程度明显小于对照组,差异有统计学意义(P<0.05)。结论:在连续血液净化中及时更换滤器较出现血凝时更换滤器更能提高疗效。
Objective: To investigate the effect of time of filter change on the treatment of severe abdominal infection in continuous blood purification. Methods: 100 cases of severe intra-abdominal infection were selected and divided into observation group and control group according to random number table method, with 50 cases in each group. Patients were treated with veno-venous hemofiltration, the observation group every 24 h to replace the filter, the control group to be replaced when the filter when the blood clot. The changes of TNF-α, IL-10, oxygenation index (OI), plasma diamine oxidase (DAO) and lipopolysaccharide (LPS) in the two groups before and after treatment were observed. Results: The levels of TNF-a and IL-10 in the two groups before and after treatment were significantly lower than those in the control group (P <0.05). The levels of OI, DAO and LPS before and after treatment in both groups were significantly different (P <0.05). With the progress of treatment, the increase of OI in observation group was significantly greater than that in control group, and the decrease of DAO and LPS in observation group was significantly less than that in control group Group, the difference was statistically significant (P <0.05). Conclusion: It is more effective to replace the filter when the filter is replaced in time than the continuous blood purification.