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目的:探讨连续血液净化(continous blood purification,CBP)治疗严重脓毒症患者的疗效及免疫调节机制分析。方法:选取我院ICU收治的严重脓毒症患者100例,随机分两组,其中采用常规疗法为对照组(50例),在对照组的基础上采用CVVH疗法为观察组(50例),比较两组患者治疗前后的各项生命体征、APACHEⅡ评分、T细胞亚群的水平及并发症发生率。结果:观察组患者血流动力学指标、氧合指数、APACHEⅡ评分、血肌酐、多器官功能衰竭发生率、ICU住院时间、机械通气时间、死亡率与对照组比较差异均有统计学意义(P<0.05)。两组在CBP治疗后,CD4+,CD3+的水平及CD4+/CD8+比值均较治疗前升高(P<0.05),而CD8+差异无统计学意义。结论:利用连续性血液净化治疗严重脓毒症,可有效除去患者毒素和致炎介质,维持内稳态,改善氧合功能,并且提高治疗的成功率。
Objective: To investigate the curative effect and immune regulatory mechanism of continuous blood purification (CBP) in patients with severe sepsis. Methods: One hundred patients with severe sepsis admitted to our hospital were randomly divided into two groups: control group (n = 50), control group (n = 50), CVVH therapy group Before and after treatment, the vital signs, APACHEⅡscore, T cell subsets and complication rates were compared between the two groups. Results: The hemodynamic parameters, oxygenation index, APACHEⅡscore, serum creatinine, incidence of multiple organ failure, length of ICU stay, duration of mechanical ventilation, mortality in the observation group were significantly different from those in the control group (P <0.05). After CBP treatment, the levels of CD4 + and CD3 + and the ratio of CD4 + / CD8 + in both groups were significantly higher than those before treatment (P <0.05), while there was no significant difference in CD8 + between the two groups. CONCLUSIONS: Continuous blood purification for severe sepsis can effectively remove toxins and pro-inflammatory mediators from patients, maintain homeostasis, improve oxygenation, and improve the success rate of treatment.