组合式血液净化治疗尿毒症抗生素脑病疗效观察

发布时间：2018-02-12 07:12

本文关键词： 组合式血液净化抗生素脑病尿毒症　出处：《中国实用内科杂志》2015年10期 　论文类型：期刊论文

【摘要】：目的探讨组合式血液净化治疗头孢菌素致尿毒症抗生素脑病患者的临床疗效。方法回顾性分析贵州省人民医院2009年10月至2014年10月收治并采用组合式血液净化治疗的44例头孢菌素致尿毒症抗生素脑病的临床资料。其中接受血液透析(HD)治疗13例,血液透析联合血液灌流组(HD+HP)治疗15例,血液透析联合血液透析滤过组(HD+HDF)治疗16例;疗程均为4周。观察3组患者治疗前后炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、降钙素原(PCT)]、生化指标[尿素氮(BUN)、血肌酐(Scr)]的变化,检测血清头孢他啶的药物浓度变化,进行格拉斯哥(GSC)评分分析。结果治疗前HD、HP+HD和HDF+HD组CRP、IL-6、PCT、BUN、Scr、头孢他啶浓度及GCS评分各指标差异均无统计学意义(P0.05)。治疗后HD、HP+HD及HDF+HD组CRP、IL-6、PCT、头孢他啶浓度、GCS评分差异均有统计学意义(P0.05)。Bun、Scr差异无统计学意义(P0.05)。HD+HP组治疗有效率达93%,且治疗时间明显缩短,差异有统计学意义(P0.05)。结论 HD+HP能更有效清除血液中头孢他啶及中大分子的炎症物质,缓解抗生素脑病临床症状,临床值得应用推广。
[Abstract]:Objective to investigate the clinical efficacy of combined blood purification in the treatment of cephalosporin-induced uremia patients with antibiotic encephalopathy. Methods retrospective analysis was made on the treatment of combined blood purification in Guizhou Provincial people's Hospital from October 2009 to October 2014. The clinical data of 44 cases of cephalosporin-induced uremia with antibiotic encephalopathy were reported. Among them, 13 cases were treated with hemodialysis and HDD. 15 cases were treated with hemodialysis combined with hemoperfusion group and 16 cases with HD HDF in hemodialysis combined with hemodiafiltration group. The course of treatment was 4 weeks. The changes of inflammatory factor (C-reactive protein CRPU, interleukin-6 IL-6, procalcitonin PCT), biochemical index [urea nitrogen bun, serum creatinine creatinine] were observed before and after treatment, and serum ceftazidime concentration was detected. Results before treatment, there were no significant differences in the levels of ceftazidime and ceftazidime between HD and HDF HD groups. After treatment, there were no significant differences in the levels of CRPIL-6PCTand ceftazidime and GCS scores between HD and HDF HD groups. There were significant differences in the levels of ceftazidime and ceftazidime in CRPIL-6PCTc and Ceftazidime in HD and HDF HD groups before and after treatment. There was no significant difference between the two groups. The effective rate of treatment was 93%, and the time of treatment was shortened obviously. Conclusion HD HP can effectively remove ceftazidime and inflammatory substances from blood and relieve the clinical symptoms of antibiotic encephalopathy.
【作者单位】：贵州省人民医院肾内科;毕节市第一人民医院肾内科;
【基金】：贵州省科技厅基金[黔科合LS字(2011)022号],[黔科合LS字(2012)033号],[黔科合LS字(2012)037号]
【分类号】：R692.5

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