ABSTRACT
Objective:To study the effect of continuous blood purification on inflammatory state and immune response in patients with multiple injury and sepsis.Methods:88 patients with multiple injury and sepsis who were treated in our hospital from January 2015 to May 2016 were selected as the research object,they were divided into the control group (n=44) and observation group (n=44) according to random number table method.The control group was given conventional treatment,and the observation group was given continuous blood purification treatment.The acute physiology and chronic health conditions Ⅱ (APACHE Ⅱ)score was observed in two groups Ⅱ at 3 d after treatment.The serum content of Interleukin-2(IL-2),Interleukin-4(IL-4),Interleukin-10(IL-10) and interferon-γ (IFN-γ) were detected by ELISA method.The levels of CD3 +,CD4 +,CD8 + and NK cell were analyzed by flow cytometry.The urea nitrogen (BUN),serum creatinine (Scr),prothrombin time (PT),thrombin time (TT),activated partial blood coagulation time (APTT) were tested by automatic biochemical analyzer.Results:The APACHE Ⅱ score,BUN and Scr levels in observation group were lower than the control group (P＜0.05).The content ofIL-2,IL-4,IL-10 and IFN-γ in observation group were lower than the control group (P＜0.05).The levels of CD3+,CD4+,CD8+ and NK in observation group were higher than the control group (P＜0.05).The levels ofPT,TT and APTT in observation group were lower than the control group (P＜0.05).Conclusion:Continuous blood purification in patients with multiple injury and sepsis had better clinical curative effect,can reduce inflammation,improve immune function and the function of blood coagulation.
ABSTRACT
Objective To observe the effects of continuous blood purification(CBP) combined with early enteral nutrition (EEN) in the treatment of acute severe acute pancreatitis(SAP) complicating hyperlipidemia.Methods Fifty-six cases of acute SAP complicating hyperlipidemia in our hospital from January 2014 to October 2015 were selected as the research subjects and divided into the CBP plus EEN group(combined group) and blood purification(BP) group according to the random digital table method,28 cases in each group.The CBP group was treated with CBP,while on the basis of CBP group the combined group was combined with EEN therapy (within 2 d after admission).The clinical efficacy and the improvement situation of various indexes after treatment were observed in the two groups.Results After treatment,the total effective rate in the combined group was 96.43 ％,which was higher than 75％ in the CBP group,the difference was statistically significant (P＜0.05);the related indicators of TG,UAMY,LPS,SAMY,CRP and LDH after treatment in the two groups were decreased,but which in the combined group were more significant compared with the CBP group(P＜0.05).After treatment,the APACHE-[[score in the combined group was significantly lower than that in the CBP group(P＜0.05),the symptom relief time and hospital stay time in the combined group were shorter than those in the CBP group (P＜0.05).The incidence rate of complications in the combined group was 10.71％,which was significantly lower than 28.57％ in the CBP group,the difference was statistically significant(P＜0.05).Conclusion CBP combined with EEN can significantly improve the prognosis of SAP patients and effectively reduces the complications.