医学信息
醫學信息
의학신식
MEDICAL INFORMATION
2013年
22期
81-81,82
,共2页
连续肾替代治疗%严重脓毒症%毛细血管渗漏综合征
連續腎替代治療%嚴重膿毒癥%毛細血管滲漏綜閤徵
련속신체대치료%엄중농독증%모세혈관삼루종합정
Continuous renal replacement therapy%Severe surgical sepsis%Vascular leak syndrome
目的：探讨连续肾替代治疗在外科严重脓毒症并发毛细血管渗漏综合征中的临床应用。方法回顾性分析2009年6月~2012年2月我院外科收治的严重脓毒症并发毛细血管渗漏综合征的40例患者的临床资料。患者均针对病因采用综合治疗，采用床旁连续肾替代疗法治疗72h。统计患者治疗前后 PCT、sST2水平的变化、血清IL-6、IL-8、TNF-水平变化以及患者死亡率。结果经过治疗，治疗后患者PCT和sST2水平、血清IL-6、IL-8、TNF-水平明显低于治疗前，差异有统计学意义（P＜0.05）；患者休克持续6~19h，水肿消退时间为3~9d，肾功能恢复正常时间为5d~4w，出院后随访2~8个月，陆续恢复正常。死亡率为7.5%，其中，2例死于MODS，1例死于肺水肿。结论应用连续肾替代治疗在外科严重脓毒症并发毛细血管渗漏综合征临床疗效确切，对于改善病情，降低病死率有重要作用。
目的：探討連續腎替代治療在外科嚴重膿毒癥併髮毛細血管滲漏綜閤徵中的臨床應用。方法迴顧性分析2009年6月~2012年2月我院外科收治的嚴重膿毒癥併髮毛細血管滲漏綜閤徵的40例患者的臨床資料。患者均針對病因採用綜閤治療，採用床徬連續腎替代療法治療72h。統計患者治療前後 PCT、sST2水平的變化、血清IL-6、IL-8、TNF-水平變化以及患者死亡率。結果經過治療，治療後患者PCT和sST2水平、血清IL-6、IL-8、TNF-水平明顯低于治療前，差異有統計學意義（P＜0.05）；患者休剋持續6~19h，水腫消退時間為3~9d，腎功能恢複正常時間為5d~4w，齣院後隨訪2~8箇月，陸續恢複正常。死亡率為7.5%，其中，2例死于MODS，1例死于肺水腫。結論應用連續腎替代治療在外科嚴重膿毒癥併髮毛細血管滲漏綜閤徵臨床療效確切，對于改善病情，降低病死率有重要作用。
목적：탐토련속신체대치료재외과엄중농독증병발모세혈관삼루종합정중적림상응용。방법회고성분석2009년6월~2012년2월아원외과수치적엄중농독증병발모세혈관삼루종합정적40례환자적림상자료。환자균침대병인채용종합치료，채용상방련속신체대요법치료72h。통계환자치료전후 PCT、sST2수평적변화、혈청IL-6、IL-8、TNF-수평변화이급환자사망솔。결과경과치료，치료후환자PCT화sST2수평、혈청IL-6、IL-8、TNF-수평명현저우치료전，차이유통계학의의（P＜0.05）；환자휴극지속6~19h，수종소퇴시간위3~9d，신공능회복정상시간위5d~4w，출원후수방2~8개월，륙속회복정상。사망솔위7.5%，기중，2례사우MODS，1례사우폐수종。결론응용련속신체대치료재외과엄중농독증병발모세혈관삼루종합정림상료효학절，대우개선병정，강저병사솔유중요작용。
Objective To explore the Clinical application of continuous renal replacement therapy in severe surgical sepsis complicated with capil ary leak syndrome. Methods:Retrospective analysis Clinical data of severe sepsis complicated with capil ary leak syndrome of 40 patients were treated in our hospital from 2009 June to 2012 February. Patients received etiology combined treatment and bedside continuous renal replacement therapy for 72h. Statistics PCT, sST2 level changes and serum IL-6, IL-8, TNF-levels before and after treatment,and Statistics the mortality of patients. Results:After treatment, PCT and sST2 levels, serum IL-6, IL-8, TNF-levels were significantly lower than before treatment, there were significant dif erence between the two proups (P<0.05);patients in shock duration 6-19h, swel ing time of 3-9d, renal function recovered in 5d-4 weeks, were fol owed up for 2-8 months, gradual y return to normal. The mortality rate was 7.5%, among them, 2 cases died of MODS, 1 case died of pulmonary edema. Conclusion:The treatment of severe surgical sepsis complicated with capil ary leak syndrome have true clinical curative ef ect,there is an important role for improve the condition and decrease the mortality.
