贵州医科大学学报

2017, v.42;No.204(09) 1063-1066

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连续血液净化对成人特重度烧伤的治疗效果
Efficacy of Continuous Blood Purification Treatment on Severe Burned Patients

包亚明;吕庆兵;肖贵喜;胡亮;贾立平;
BAO Yaming;LV Qingbing;XIAO Guixi;HU Liang;JIA Liping;Department of Burns and Orthopedics,Kunshan First People's Hospital Affiliated to Jiangsu University;

摘要(Abstract):

目的:观察连续血液净化治疗对成人特重度烧伤的治疗效果。方法:将26例特重度烧伤成人患者均分为常规治疗组和净化治疗组,净化治疗组在常规治疗组治疗的基础上,于病程48 h时加用连续血液净化治疗;分别在病程48、72、96、120及144 h时,测定2组患者的白细胞(WBC)及血清降钙素原(PCT)水平,抽取股动脉血进行血气分析,测定血乳酸含量、氧分压(Pa O2),记录吸氧浓度并计算氧合指数(OI),采用酶联免疫吸附法测定肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)及IL-8水平。结果:净化治疗组在病程48 h开始进行血液净化治疗,在病程72、96、120及144 h所测定的WBC、PCT、乳酸、TNF-α、IL-6及IL-8水平均明显低于常规治疗组(P<0.05),OI明显高于常规治疗组(P<0.05);与治疗前比较,常规治疗组在病程72、96、120及144 h所测定的WBC、PCT、TNF-α、IL-6、IL-8、乳酸及OI水平接近,而净化治疗组WBC、PCT、TNF-α、IL-6、IL-8水平及乳酸含量比治疗前明显降低(P<0.05),OI含量明显升高(P<0.05)。结论:成人特重度烧伤时在常规治疗时给予连续血液净化治疗效果优于单一的常规治疗。
Objective: To observe the therapeutic effect of continuous blood purification for the severe burned patients. Methods: 26 cases of severe burned patients were randomly divided into routine treatment group and continuous blood purification treatment group,13 cases in each group. In the course of48 hours after the routine treatment,the continuous blood purification group then was treated with continuous blood purification. In 48 hours,72 hours,96 hours,120 hours and 144 hours measured the blood routine test,blood biochemistry,procalcitonin( PCT) level,partial pressure of oxygen content of blood lactic acid,femoral artery blood gas analysis( Pa O2),oxygen concentration record and calculate the oxygenation index( OI),enzyme ELISA determination was adopted to detect TNF alpha,IL-6and IL-8 level. Results: WBC,PCT,lactic acid,TNF-a,IL-6 and IL-8 level of continuous blood purification treatment group detected in 72 hours,96 hours,120 hours,144 hours were significantly lower than that of the conventional treatment group( P < 0. 05),OI was obviously higher than conventional treatment group( P < 0. 05); WBC,PCT,TNF-a,IL-6 and IL-8,lactic acid and OI level of conventional treatment group in 72 hours,96 hours,120 hours and 144 hours were close,while WBC,PCT,TNF-a,IL-6 and IL-8,lactic acid of continuous blood purification treatment group were obviously lowered compared with before treatment( P < 0. 05),OI content was obviously increased( P < 0. 05). Conclusions: The use of continuous blood purification on the basis of conventional treatment for severe burns is better than conventional treatment.

关键词(KeyWords): 烧伤,特重度;血液净化;肿瘤坏死因子-α;白细胞介素-6;白细胞介素-8;脓毒血症;治疗结果
burns;especially severe;blood purification;tumor necrosis factor alpha;interleukin-6;interleukin-8;sepsis;treatment outcome

Abstract:

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基金项目(Foundation): 江苏省昆山市社会发展科技专项(KS1642)

作者(Author): 包亚明;吕庆兵;肖贵喜;胡亮;贾立平;
BAO Yaming;LV Qingbing;XIAO Guixi;HU Liang;JIA Liping;Department of Burns and Orthopedics,Kunshan First People's Hospital Affiliated to Jiangsu University;

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DOI: 10.19367/j.cnki.1000-2707.2017.09.015

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