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Continuous Blood Purification Technology for the Treatment of Critically Ill Patients (Accompanied by Analysis of Clinical Data of 534 Cases)

Author: HuXueQin
Tutor: ZhouHongWei
School: Guangxi Medical University
Course: Internal Medicine
Keywords: Continuous blood purification Critically ill patients Clinical efficacy
CLC: R459.7
Type: Master's thesis
Year: 2009
Downloads: 130
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Abstract


The purpose of continuous blood purification (CBP) Learn more about technical role in the treatment of critically ill patients, to evaluate the clinical efficacy of CBP in the treatment of critically ill patients. Methods A retrospective analysis of the First Affiliated Hospital of Guangxi Medical Stayed July 2003 to October 2008, 534 cases of critically ill patients in the intensive care unit of our hospital (severe, severe, CCU) were analyzed and summarized, explore the CBP effects and clinical efficacy of the treatment of critically ill patients, depending on the treatment into the treatment group and the control group. Conventional treatment line continuous blood purification treatment of patients as a treatment group, 331 cases; over the same period did not undergo the treatment of CBP and only line of conventional treatment of patients as a control group of 203 cases (patients due to economic reasons, refuse to accept the CBP treatment or ideas temporarily can not accepted CBP invasive procedures). Observed in both groups of patients before treatment (set to 0h) and after treatment, 24h, 48h, 72h body temperature, breathing, heart rate, mean arterial pressure, serum creatinine, blood urea nitrogen, serum potassium, serum sodium, white blood cell count and arterial oxygenation index PH value, the BE value and Acute Physiology and Chronic Health (APACHE II) score, changes in these indicators were observed and 72h survival, the end of mortality and the clinical data were statistically analyzed. Results of the treatment of former CBP treatment group, no significant difference in the severity of the condition of the control group that did not undergo the treatment of CBP 0h treatment group and the control group APACHE II score was no statistical difference between treatment groups in the 24h, 48h APACHE II scores decreased after 72 hours , compared with before treatment, the difference was statistically significant (p lt; 0.05), compared with the control group difference was statistically significance (p lt; 0.05). Blood PH value of the the CBP treatment group compared with the control group, oxygenation index, creatinine, urea nitrogen indicators after treatment, 24h, 48h, 72h a significant improvement, the difference was statistically significant (p lt; 0.05); the CBP treatment process, the average arterial pressure compared with before treatment and after treatment with the control group, the difference was not statistically significant, suggesting stable hemodynamics, renal function and biochemical indicators compared with the control group improved continuous blood purification process. The survival rate of 82.48 percent CBP treatment group 72h 72h survival rate of 55.17% in the control group, the two groups have a significant difference (p lt; 0.01). The end of observation: the the CBP treatment group, 43 cases (12.90%) accept CBP treatment, treatment and discharged due to economic and other reasons to give up but have not yet reached the end of treatment (still the CBP treatment of indications), 152 cases (45.92%) died, 136 cases (41.09%) improved back to the general ward or local hospital for further treatment. 31 cases (15.20%) in the control group to give up treatment and discharged 103 deaths (50.74%), improved in 69 cases (33.40%) back to the general ward or local hospital to continue treatment. Two sets of mortality comparison: the treatment group vs control group: 55.82% vs 65.94%, and the difference was statistically significant (p lt; 0.05). Conclusion complex illness of critically ill patients, critically ill, with high mortality, treatment diversity, to emphasize multiple organ support, and in the course of treatment to take steady, sustained, and effective treatment in order to play an active role. CBP hemodynamic stability, solute clearance rate, on the basis of conventional therapy plus continuous blood purification treatment of critically ill patients, to correct environmental balance disorders, maintain homeostasis, improve serum markers to improve patient liquid load overweight caused by pulmonary edema, respiratory dysfunction, improve microcirculation failure caused by circulatory dysfunction caused by acidosis, vascular paralysis, is conducive to the improvement of patients with renal and respiratory function, suitable for the treatment of critically ill patients. CBP can significantly improve the 72h survival in critically ill patients, the lower end point of mortality, is an effective means to treat critically ill patients.

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