Continuous renal replacement therapy in treatment of patients with severe multiple injury / 中国基层医药

ABSTRACT

Objective To evaluate the value of continuous vent*venous hemofiltration(CVVH) in hindering systemic inflammatory response syndrome(SIRS) of severe multiple injury to proceed to multiple organ dysfunction syndrome(MODS). Methods 58 patients were randomly divided into routine group(n =31) and CVVH group(n = 27). Both groups were given routine treatment,while the patients in the CVVH group were given CVVH in addition. Additionally ,20 healthy persons were enrolled as normal group. The condition of SIRS were observed, and the serum C reactive protein(CRP)., tumor necrosis factor-α(TNF-α) , interleuldn-6 (IL-6), interleuldn- Ⅰβ(IL- Ⅰβ) levels were measured before and after treatment in CVVH group,routine group and in normal group at the time of health examina-tion. Results Temperature(T), respiration rate (RR) , heart rate (HR) and white blood cell (WBC) were reduced significantly in CVVH group(P < 0.05 or P < 0.01). The serum CRP, TNF-α, IL- Ⅰβ and IL-6 levels of CVVH group were reduced significantly(P <0.01). The number of patients with duration of SIRS were fewer and the incidence of MODS was lower in CVVH group than those in routine group(P <0.05) ,and the fatality rate was reduced significant-ly in CVVH group(P < 0.05). Conclusion CVVH would significantly improve the inflammatory symptom and signs of SIRs,inhibit the production of inflammatory cytokines in the treatment of SIRS. It can effectively prevent SIRS of severe multiple injury to proceed to MODS.