本文選題：持續(xù)腎臟替代治療 + SIRS　； 參考：《青島大學(xué)》2013年碩士論文

【摘要】：目的 應(yīng)用連續(xù)性腎臟替代治療(CRRT)技術(shù)治療全身炎癥反應(yīng)綜合征(SIRS),探討治療期間病人相關(guān)的免疫和炎性指標(biāo)的變化及意義；同時(shí)判斷其對(duì)預(yù)后的影響。 方法 選取2011年12月至2013年3月入住青島市立醫(yī)院ICU的SIRS病人52例,其中常規(guī)內(nèi)科治療的同時(shí)行CRRT治療的病人26例(CRRT組),僅進(jìn)行常規(guī)內(nèi)科治療的病人26例(對(duì)照組)。分別于治療前和治療結(jié)束后采取靜脈血檢測C-反應(yīng)蛋白(CRP)、血常規(guī)、T細(xì)胞亞群,采取動(dòng)脈血做血?dú)夥治�。此�?進(jìn)行急性生理學(xué)和慢性健康評(píng)估Ⅱ(APACHE Ⅱ)評(píng)分,并對(duì)其進(jìn)行比較分析。 結(jié)果 1、CRRT組存活19例,死亡7例,存活率73.08%。對(duì)照組存活10例,死亡16例,存活率38.46%。 2、CRRT組治療后與治療前比,CRP、白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞計(jì)數(shù)、單核細(xì)胞計(jì)數(shù)、APACHE Ⅱ評(píng)分、PCO2和血乳酸值下降(P0.05),CD3+、CD4+和NK細(xì)胞增多,有統(tǒng)計(jì)學(xué)意義(P0.01)。 3、對(duì)照組CRP、中性粒細(xì)胞計(jì)數(shù)、白細(xì)胞計(jì)數(shù)、PCO2、APACHE Ⅱ評(píng)分和CD3+變化有意義,其余指標(biāo)無差異(P0.05)。 4、CRRT組與對(duì)照組治療前,各指標(biāo)均無差異(P0.05)。治療后比較, CRP、白細(xì)胞計(jì)數(shù)、中性粒細(xì)胞計(jì)數(shù)、單核細(xì)胞計(jì)數(shù)、PH值、PCO2、APACHE Ⅱ評(píng)分、血乳酸、CD3+和CD4+變化有意義(P0.05)。 結(jié)論 1CRRT可降低SIRS患者血液中的炎性相關(guān)指標(biāo)(CRP、白細(xì)胞、中性粒細(xì)胞和單核細(xì)胞)濃度,下調(diào)機(jī)體炎癥反應(yīng),減輕過度激活炎癥介質(zhì)對(duì)機(jī)體的影響。 2CRRT治療可更好維持體內(nèi)酸堿代謝的平衡,維持內(nèi)環(huán)境穩(wěn)定。 3CRRT可上調(diào)T細(xì)胞亞群水平,改善機(jī)體免疫系統(tǒng),促進(jìn)機(jī)體自身免疫功能的恢復(fù),重建機(jī)體內(nèi)環(huán)境平衡。 4CRRT治療后,APACHE Ⅱ評(píng)分和血乳酸值降低顯著。提示CRRT可更好控制SIRS病情的發(fā)生發(fā)展,改善預(yù)后。
[Abstract]:PurposeContinuous renal replacement therapy (CRRTT) was used to treat systemic inflammatory response syndrome (SIRSN). The changes and significance of immune and inflammatory indexes in patients with systemic inflammatory response syndrome (Sirs) during the treatment were discussed, and the influence of CRRTT on prognosis was evaluated.Method52 SIRS patients admitted to Qingdao Municipal Hospital from December 2011 to March 2013 were selected. Among them, 26 cases were treated with routine internal medicine and 26 cases were treated with CRRT, and 26 cases were treated with routine internal medicine only (control group).Before and after treatment, venous blood was used to detect C-reactive protein (CRP), blood routine T cell subsets and arterial blood were used for blood gas analysis.In addition, acute physiology and chronic health assessment 鈪，

本文編號(hào)：1760413