连续血液净化串联血液灌流治疗尿源性脓毒血症的效果分析[权威资料].docVIP

连续血液净化串联血液灌流治疗尿源性脓毒血症的效果分析 　　[摘要] 目的 探讨连续血液净化串联血液灌流治疗尿源性脓毒血症患者的临床疗效。 方法 回顾分析2010年1月～2015年6月我院收治患者中出现尿源性脓毒血症的23例患者的临床资料，采用常规液体复苏治疗基础上结合连续血液净化串联血液灌流治疗，比较其治疗前、后生命体征，肾功能及炎症指标水平的变化。 结果 除1例患者死亡外，其余经治疗患者生命体征在48 h后基本趋于稳定，感染检测指标与SCr均有下降，治疗72 h后，降钙素原、C-反应蛋白及细胞因子TNF-α、IL-6的水平与治疗前比较明显降低，差异有统计学意义（P0.05）。平均住院天数为11 d，无明显后遗症。 结论 尿源性脓毒血症重在预防，泌尿系感染患者术前应规范抗感染治疗，术中密切观察，出现血压下降、寒战或创面异常出血等应立即终止手术，及时采取液体复苏并应用连续血液净化串联血液灌流，可降低尿源性脓毒血症患者的炎性介质水平，有效控制病情发展。 　　[关键词] 尿源性脓毒血症；连续血液净化；液体复苏；血液灌流 　　[] R459.5 [] A [] 1674-4721（2016）05（a）-0060-04 　　Clinical effects of continuous blood purification in tandem with hemoperfusion in the treatment of urogenous sepsis 　　CHEN Shen-quan1 LI Jian-fei2 CHEN Yi-ming3 WU Bao-zhong1 　　1.Department of Urology，the Second People′s Hospital in Zhaoqing City of Guangdong Province，Zhaoqing 526060，China；2.ICU，the Second People′s Hospital in Zhaoqing City of Guangdong Province，Zhaoqing 526060，China；3.CCU，the Second People′s Hospital in Zhaoqing City of Guangdong Province，Zhaoqing 526060，China 　　[Abstract] Objective To investigate the clinical effects of continuous blood purification in tandem with hemoperfusion in the treatment of patients with urogenous sepsis. Methods 23 patients with urogenous sepsis who were admitted in our hospital from January 2010 to June 2015 were retrospectively analyzed.Continuous blood purification in tandem with hemoperfusion on the basis of conventional fluid resuscitation was performed on the patients.The changes of vital signs，kidney functions and inflammation indexes level before and after the treatment were compared. Results Besides 1 case of death，the vital signs of all the other patients tended to be stable 48 hours after the treatment and the infection-detective indexes as well as the SCr was decreased respectively.Among them，the level of procalcitonin，C-reactive protein，cytokines TNF-αand IL-6 72 hours after the treatment was all significantly lower than that before the treatment respectively and the differ