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目的评估连续性血液净化技术(CBP)治疗重型流感的临床疗效。方法将重型流感患者分为两组,观察组早期进行CBP治疗,对照组未进行CBP治疗,通过监测患者生命体征、急性生理与慢性健康(APACHE II)评分、序贯器官功能衰竭(SOFA)评分、氧合指数(Pa O2/Fi O2)、C反应蛋白(CRP)、平台压(Pplat)、病毒清除情况等指标。比较两组患者的炎症反应、肺损伤程度及死亡率。结果观察组及对照组治疗前的APACHEⅡ评分、SOFA评分、Pa O2/Fi O2、CRP和Pplat比较差异均无统计学意义(P>0.05)。经治疗后观察组患者的APACHEⅡ评分为12.9±7.5,SOFA评分为4.3±3.6,CRP为(46.3±29.9)mg/L,Pplat为(15.1±4.9)cm H2O,死亡率3.84%,而观察组的Pa O2/Fi O2为299.0±35.3,明显高于对照组的276.2±33.9,两组差异有统计学意义(P<0.05)。观察组中患者继发细菌性肺炎及呼吸系统细菌感染的发生率低于对照组,两组差异有统计学意义(P<0.05)。结论早期应用连续性血液净化技术可安全有效应用于重型流感患者,因此它可以考虑作为治疗重型流感的一个重要手段。
Objective To evaluate the clinical efficacy of continuous blood purification (CBP) in the treatment of severe influenza. Methods The patients with severe influenza were divided into two groups. The observation group was treated with CBP in the early stage, while the control group was not treated with CBP. The vital signs, acute physiology and chronic health (APACHE II) scores, sequential organ failure (SOFA) , Pa O2 / Fi O2, CRP, Pplat and virus clearance were measured. Inflammation, lung injury and mortality were compared between the two groups. Results There were no significant differences in APACHEⅡscore, SOFA score, PaO2 / Fi O2, CRP and Pplat between the observation group and the control group before treatment (P> 0.05). The APACHE II score of the observation group was 12.9 ± 7.5, the SOFA score was 4.3 ± 3.6, the CRP was (46.3 ± 29.9) mg / L, the Pplat was (15.1 ± 4.9) cm H2O and the death rate was 3.84% PaO2 / Fi O2 was 299.0 ± 35.3, which was significantly higher than that of the control group (276.2 ± 33.9), the difference was statistically significant (P <0.05). The incidence of secondary bacterial pneumonia and respiratory bacterial infection in the observation group was lower than that in the control group, with significant difference between the two groups (P <0.05). Conclusion Early application of continuous blood purification can be safely and effectively applied to patients with severe influenza, so it can be considered as an important treatment for severe influenza.