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目的评价早期高容量血液滤过对心肺复苏后综合征患者预后的影响。方法 44例心肺复苏后综合征患者,随机分为试验组和对照组,各22例。试验组于入院6 h内实施早期高容量血液滤过治疗,对照组在入院6 h后实施高容量血液滤过治疗,观察2组患者治疗前、治疗6 d后急性生理与慢性健康评分(APACHEⅡ)、多器官功能障碍综合征(MODS)评分、血清C反应蛋白(CRP)、血清降钙素原(PCT)水平变化以及多巴胺用量、平均动脉压、氧合指数变化情况。结果 2组患者治疗后APACHEⅡ评分、MODS评分以及血清CRP、PCT水平与治疗前相比均得到改善、多巴胺用量显著降低(P<0.05),其中试验组治疗后APACHEⅡ评分、MODS评分、多巴胺用量、血清CRP、PCT水平明显低于对照组(P<0.05),而平均动脉压与氧合指数均显著高于对照组(P<0.05)。结论早期高容量血液滤过对心肺复苏后综合征患者预后有积极意义。
Objective To evaluate the effect of early high-volume hemofiltration on the prognosis of post-cardiopulmonary resuscitation syndrome patients. Methods Forty-four patients with post-CPR syndrome were randomly divided into experimental group and control group, with 22 cases in each group. In the experimental group, early high-volume hemofiltration was performed within 6 hours after admission. In the control group, high-capacity hemofiltration was performed 6 hours after admission. The acute physiology and chronic health scores (APACHEⅡ (MODS), serum C-reactive protein (CRP), serum procalcitonin (PCT) levels, dopamine dosage, mean arterial pressure and oxygenation index. Results APACHEⅡscores, MODS scores, serum CRP and PCT levels in both groups were significantly improved compared with those before treatment, and the dosage of dopamine was significantly decreased (P <0.05). The APACHEⅡscore, MODS score, dopamine dosage, Serum CRP and PCT levels were significantly lower than those in the control group (P <0.05), while mean arterial pressure and oxygenation index were significantly higher than those in the control group (P <0.05). Conclusion Early high-volume hemofiltration has a positive effect on the prognosis of patients with post-CPR syndrome.