妊娠期高甘油三酯血症透析治疗期间三酰甘油及炎症因子的变化与护理对策分析
The changes of triacylglycerol and inflammatory factors during dialysis treatment of hypertriglyceridemia during pregnancy and analysis of nursing countermeasure.
作者信息
Guo Lin, Rong Lingzhi, Xu Xuewei
机构信息
Physical Examination Center of Traditional Chinese Medicine Hospital, Penglai Hospital of Traditional Chinese Medicine Penglai, Shandong, China.
Department of Gynecology and Obstetrics of Dongying Second People's Hospital Dongying, Shandong, China.
出版信息
Am J Transl Res. 2021 Jun 15;13(6):6745-6751. eCollection 2021.
OBJECTIVE
To investigate the changes of triacylglycerol and inflammatory factors after hypertriglyceridemia acute pancreatitis (HTG-AP) dialysis during pregnancy and to analyze the nursing strategies.
METHODS
50 patients treated with HTG-AP dialysis in our hospital from February 2017 to June 2019 were selected. The patient's vital signs, triglyceride (TG), total cholesterol (TC), TG and TC decline rates before treatment, 1, 3, and 5 days after treatment and inflammatory factors [tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β), Interleukin-6 (IL-6), Interleukin-10 (IL-10) level changes] were measured, as well as the acute physiological and chronic health evaluation II (APACHEII), multiple organ dysfunction syndromes (MODS), systemic inflammatory response syndrome (SIRS) and maternal treatment outcomes.
RESULTS
There was no significant change in body temperature before and after treatment (P>0.05); The heart rate, WBC, CRP before and after treatment were statistically different (P<0.05); Compared with before treatment, serum levels of TG and TC significantly decreased after treatment, and the rate of decrease was significantly increased (P<0.05); Compared with before treatment, the levels of inflammatory factors (TNF-α, IL-1β, IL-6, IL-10) gradually decreased after treatment, and the serum levels of patient's TNF-α, IL-1β, IL-6, IL-10 after 5 days of treatment were more significant (P<0.05); Compared with before treatment, APACHEll, MODS and SIRS scores significantly decreased after treatment, and APACHEll, MODS and SIRS scores were better after 5 days of treatment (P<0.05); The mortality rate during treatment was 2.00%; the complication rate was 32.00%, including 5 cases of acute respiratory distress syndrome, 4 cases of pleural effusion, 4 cases of lung infection, 2 cases of acute renal insufficiency and 1 case of shock.
CONCLUSION
Dialysis treatment can promote the recovery of HTG-AP patients promptly, improve triglycerides, and reduce inflammation. After the targeted nursing intervention, the treatment efficacy significantly improved.
目的
探讨妊娠合并高甘油三酯血症性急性胰腺炎(HTG-AP)透析治疗后甘油三酯及炎症因子的变化,并分析护理策略。
方法
选取2017年2月至2019年6月在我院接受HTG-AP透析治疗的50例患者。测量患者的生命体征、甘油三酯(TG)、总胆固醇(TC)、治疗前、治疗后1天、3天和5天的TG和TC下降率以及炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平变化],以及急性生理与慢性健康状况评分系统II(APACHEII)、多器官功能障碍综合征(MODS)、全身炎症反应综合征(SIRS)和产妇治疗结局。
结果
治疗前后体温无显著变化(P>0.05);治疗前后心率、白细胞、C反应蛋白有统计学差异(P<0.05);与治疗前相比,治疗后血清TG和TC水平显著降低,下降率显著升高(P<0.05);与治疗前相比,治疗后炎症因子(TNF-α、IL-1β、IL-6、IL-10)水平逐渐降低,治疗5天后患者血清TNF-α、IL-1β、IL-6、IL-10水平降低更显著(P<0.05);与治疗前相比,治疗后APACHEll、MODS和SIRS评分显著降低,治疗5天后APACHEll、MODS和SIRS评分更好(P<0.05);治疗期间死亡率为2.00%;并发症发生率为32.00%,包括急性呼吸窘迫综合征5例、胸腔积液4例、肺部感染4例、急性肾功能不全2例、休克1例。
结论
透析治疗能促使HTG-AP患者迅速康复,改善甘油三酯水平,减轻炎症反应。针对性护理干预后,治疗效果显著提高。