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目的:探讨早期连续性肾脏替代治疗(CRRT)对急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)患者的治疗作用。方法:将广西科技大学附属柳州市人民医院2012年2月至2014年2月收治的20例ALI/ARDS患者,随机分为对照组、治疗组,各10例。两组均采用常规综合治疗+呼吸机治疗,治疗组另加用CRRT治疗。检测并比较两组患者氧合指数(PaO_2/FiO_2)、超敏C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α),炎症因子白介素-6(IL-6)的变化,比较两组患者机械通气时间及住重症监护室(ICU)时间。结果:与对照组比较,治疗组PaO_2/FiO_2上升,CRP、TNF-α、IL-6下降,机械通气时间及住ICU时间缩短,组间比较,差异具有统计学意义(P<0.05)。结论:早期连续性肾脏替代治疗可改善ALI/ARDS患者的PaO_2/FiO_2,降低炎症因子,缩短机械通气时间及住ICU时间,对ALI/ARDS患者可能有益。
Objective: To investigate the therapeutic effect of early continuous renal replacement therapy (CRRT) on patients with acute lung injury (ALI) / acute respiratory distress syndrome (ARDS). Methods: Twenty ALI / ARDS patients admitted to Liuzhou People’s Hospital affiliated to Guangxi University of Science and Technology from February 2012 to February 2014 were randomly divided into control group and treatment group, with 10 cases in each group. Both groups were treated by conventional combined therapy and ventilator, and the treatment group was additionally treated with CRRT. The changes of oxygenation index (PaO 2 / FiO 2), high sensitivity C-reactive protein (CRP), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) Two groups of patients with mechanical ventilation and intensive care unit (ICU) time. Results: Compared with the control group, the PaO 2 / FiO 2 increased, the levels of CRP, TNF-α and IL-6 decreased, the time of mechanical ventilation and ICU stay shortened in the treatment group. The difference was statistically significant (P <0.05). CONCLUSIONS: Early continuous renal replacement therapy may improve PaO_2 / FiO_2, decrease inflammatory cytokines, shorten duration of mechanical ventilation and ICU stay in ALI / ARDS patients, which may be beneficial for patients with ALI / ARDS.