Objective To investigate the effects of combined use of Xuebijing and CVVH on PLT,TBil and Cr in elderly patients with multiple organ dysfunction syndrome.Methods Ninety-four cases of elderly patients with multiple organ dysfunction syndrome were selected,which were treated in hospital ICU hospitalization from March 2013 to March 2017,and they were divided into the observation group (47 cases) and control group (47 cases).The patients of two groups were all treated with conventional comprehensive treatment.The patients of control group were treated with CVVH (blood flow rate 200 ml/min,ultrafiltration volume 150-300 ml/min,replacement fluid flow 3 000 ml/h,continuous treatment for 1-4d).Based on control group,the patients of observation group were treated with Xuebijing injection (intravenous infusion of 100 ml times,3 times / d,treatment for 7d).Compare the clinical efficacy,ventilator support time and ICU hospital stay and changes of the levels of SCr,BUN,IL-1β,IL-10,TNF-α,TBil,PLT,PaO2,PaO2/FiO2,APACHE Ⅱ scores of two groups.Results After the appropriate treatment,the total effective rate of the observation group was 91.5％,which was significantly higher than 74.5％ of the control group (x2 =4.821,P =0.028);In terms of ventilator support time,ICU hospitalization time,PLT and APACHEⅡscore,the performance of the observation group was significantly better than the control group (P ＜ 0.05);The TBil,PaO2,PaO2/FiO2 of the two groups were significantly improved than before,and the patients in the observation group improved more significantly (P ＜ 0.05);The SCr,BUN of the two groups were significantly decreased than before,and the patients in the observation group decreased more significantly (P ＜ 0.05);The IL-1β,IL-10,TNF-α of the two groups were significantly decreased than before,and the patients in the observation group decreased more significantly (P ＜ 0.05).Conclusion Combined use of Xuebijing and CVVH in the treatment of elderly patients with multiple organ dysfunction syndrome can get the exact effect,significantly improve the organ function and prognosis,which makes it worthy of clinical application.%目的 观察血必净联合连续性静脉—静脉血液滤过(CVVH)治疗多脏器功能障碍综合征(MODS)效果及对炎性因子的影响.方法 选择2013年3月-2017年3月无锡市第三人民医院ICU住院治疗的MODS患者94例作为研究对象,随机数字表法分为观察组和对照组各47例.2组患者均给予常规综合治疗,对照组在常规治疗基础上联合应用CVVH治疗,血液流速200 ml/min,超滤量150 ～ 300 ml/min,置换液流量3 000 ml/h,持续时间1～4d;观察组在对照组治疗基础上联合应用血必净注射液100 ml静脉滴注,3次/d,疗程为7d.观察呼吸机支持时间及ICU住院时间,比较2组患者临床疗效,治疗前后SCr、BUN、IL-1β、IL-10、TNF-α、TBil、PLT、PaO2、PaO2/FiO2、APACHEⅡ变化情况.结果 观察组总有效率为91.5％,高于对照组的74.5％(x2=4.821,P=0.028).观察组患者在呼吸机支持时间、ICU住院时间、PLT及APACHEⅡ评分方面的表现均明显优于对照组,差异均有统计学意义(P＜0.05,P ＜0.01).治疗后2组患者TBil明显降低,PaO2、PaO2/FiO2显著升高(P＜0.05),SCr、BUN水平降低(P＜0.05);IL-1β、IL-10、TNF-α水平降低(P＜0.05);与对照组比较,观察组治疗后上述指标改善更明显,差异均有统计学意义(P＜0.05).结论 血必净联合CVVH联合治疗多脏器功能障碍患者疗效确切,能显著改善脏器功能及预后,值得临床推广应用.
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