论文部分内容阅读
目的探讨血浆置换(PE)联合连续性肾脏替代治疗(CRRT)对重症肝炎患者血清炎性介质及预后的影响。方法选取成都市第五人民医院2014年6月—2016年12月收治的重症肝炎90例,按治疗方法分为A、B、C组,每组30例。C组予以PE+内科常规治疗,A组在C组基础上给予8~12 h 20 L CRRT,B组在C组基础上给予20~24 h 40 L CRRT。观察3组治疗前后血清炎性介质变化情况及预后。结果 3组治疗后血清炎性因子水平均低于治疗前,且A、B组低于C组(P<0.05)。随访半年后,3组总好转率比较差异无统计学意义(P>0.05)。结论 PE联合CRRT治疗重症肝炎可降低患者血清炎性介质表达水平,提高治疗效果,不同剂量的置换液对CRRT治疗效果无明显影响。
Objective To investigate the effect of plasma exchange (PE) combined with continuous renal replacement therapy (CRRT) on serum inflammatory mediators and prognosis in patients with severe hepatitis. Methods Ninety patients with severe hepatitis admitted to Chengdu Fifth People’s Hospital from June 2014 to December 2016 were selected and divided into A, B and C groups according to the treatment method, 30 cases in each group. Group C was treated with PE and conventional medicine. Group A was given 8-12 h 20 L CRRT on the basis of group C. Group B received 20-24 h 40 L CRRT on the basis of group C. Serum inflammatory mediators and prognosis were observed before and after treatment in 3 groups. Results The levels of serum inflammatory cytokines in the three groups after treatment were lower than those before treatment, and those in groups A and B were lower than those in group C (P <0.05). After six months of follow-up, there was no significant difference in total improvement rate between the three groups (P> 0.05). Conclusion PE combined with CRRT can reduce the level of serum inflammatory mediators in patients with severe hepatitis and improve the therapeutic effects. Different doses of replacement fluid have no significant effect on the therapeutic effect of CRRT.