CAJ | 학술논문

目的探讨全身炎症反应综合征(SIRS)患者进行全血吸附(AP)并联连续性静脉-静脉血液滤过(CVVH)清除血清炎症介质的效果和护理要点.方法将63例SIRS患者随机分为治疗组(AP并联CVVH方法)31例和对照组(单纯CVVH方法)32例,记录患者治疗前后血清炎症介质(TNF、CRP、IL-1、IL-6和IL-10)数值并进行组内和组间统计学比较.结果两组患者治疗前TNF、CRP、IL-1、IL-6、IL-10比较差异无统计学意义(P＞0.05).治疗后2,26,50h治疗组TNF、CRP、IL-1、IL-6和IL-10水平呈下降趋势,与治疗前比较差异均有统计学意义(P＜0.05).治疗后2,26,50 h对照组TNF、CRP、IL-1、IL-6和IL-10水平呈下降趋势,与治疗前比较,治疗后2h差异无统计学意义(P＞0.05),治疗后26,50 h差异有统计学意义(P＜0.05).治疗后相同时间点治疗组与对照组TNF、CRP、IL-1、IL-6和IL-10水平比较差异有统计学意义(P＜0.05),如TNF,治疗后2,26,50h治疗组分别为(226.4 ±27.6),(165.3±24.5),(120.6±19.2)ng/L,对照组分别为(315.7±38.3),(262.7±29.4),(219.3±25.6) ng/L,差异均有统计学意义(t值分别为-3.31,-7.19,-8.79;P ＜0.05).结论 AP并联CVVH能有效清除SIRS患者血清中的炎症介质.护理人员的严密监测和护理是治疗顺利进行并达到预期目标的重要环节.
목적 탐토전신염증반응종합정(SIRS)환자진행전혈흡부(AP)병련련속성정맥-정맥혈액려과(CVVH)청제혈청염증개질적효과화호리요점.방법 장63례SIRS환자수궤분위치료조(AP병련CVVH방법)31례화대조조(단순CVVH방법)32례,기록환자치료전후혈청염증개질(TNF、CRP、IL-1、IL-6화IL-10)수치병진행조내화조간통계학비교.결과 량조환자치료전TNF、CRP、IL-1、IL-6、IL-10비교차이무통계학의의(P＞0.05).치료후2,26,50h치료조TNF、CRP、IL-1、IL-6화IL-10수평정하강추세,여치료전비교차이균유통계학의의(P＜0.05).치료후2,26,50 h대조조TNF、CRP、IL-1、IL-6화IL-10수평정하강추세,여치료전비교,치료후2h차이무통계학의의(P＞0.05),치료후26,50 h차이유통계학의의(P＜0.05).치료후상동시간점치료조여대조조TNF、CRP、IL-1、IL-6화IL-10수평비교차이유통계학의의(P＜0.05),여TNF,치료후2,26,50h치료조분별위(226.4 ±27.6),(165.3±24.5),(120.6±19.2)ng/L,대조조분별위(315.7±38.3),(262.7±29.4),(219.3±25.6) ng/L,차이균유통계학의의(t치분별위-3.31,-7.19,-8.79;P ＜0.05).결론 AP병련CVVH능유효청제SIRS환자혈청중적염증개질.호리인원적엄밀감측화호리시치료순리진행병체도예기목표적중요배절.
Objective To discuss the effect of absorption (AP) combined with continuous venovenous hemofiltration (CVVH) on eliminating serum inflammatory medium for patients with systemic inflammatory response syndrome (SIRS) and its nursing essence.Methods Totals of 63 patients with SIRS were randomly divided into the treatment group (AP combined with CWH,n =31) and the control group (CWH,n =32).Data of serum inflammatory medium,such as TNF,CRP,IL-1,IL-6 and IL-10 were recorded and compared within and between two groups before and after the treatment.Results There was no statistically significant difference in TNF,CRP,IL-1,IL-6 and IL-10 between two groups before treatment (P ＞ 0.05).After the treatment,levels of TNF,CRP,IL-1,IL-6 and IL-10 in 2,26 and 50 hours showed descending tendency in the treatment group,and the differences were statistically significant compared with before (P ＜ 0.05).Levels of TNF,CRP,IL-1,IL-6 and IL-102,26 and 50 hours after the treatment in the control group also showed descending tendency,and the differences were statistically significant compared with before (P ＜ 0.05) except data in 2 hours (P ＞ 0.05).Levels of TNF,CRP,IL-1,IL-6 and IL-10 also had statistically significant differences between two groups at the same time (P ＜ 0.05).For example,score of TNF was respectively (226.4±27.6),(165.3 ±24.5),(120.6 ± 19.2) ng/L 2,26 and 50 hours after treatment in the treatment group and (315.7 ± 38.3),(262.7 ± 29.4),(219.3 ± 25.6) ng/L in the control group,with statistically significant differences (t =-3.31,-7.19,-8.79,respectively; P ＜ 0.05).Condusions AP combined with CVVH can effectively eliminate the serous inflammatory medium for SIRS patients,and close surveillance and nursing are key to smooth treatment and expectations achievement.