Fan Xing, Li Zhe, Gao Yan, Zhang Hai-Song, Bi Zhao-Yu
Xing Fan, Department of Nephrology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China.
Zhe Li, Department of Nephrology, Affiliated Hospital of Hebei University, Baoding 071000, Hebei, China.
Pak J Med Sci. 2024 May-Jun;40(5):1030-1034. doi: 10.12669/pjms.40.5.8386.
To detect the continuous blood purification (CBP)'s application value in patients with urosepsis caused by ureteral calculi and heart failure after catheterization.
This is a clinical comparative study. Sixty patients with ureteral calculi complicated with heart failure and urosepsis were admitted at Affiliated Hospital of Hebei University from January 2021 to March 2023 randomly split into control and experimental group(n=30). Based on conventional treatment after indwelling the DJ tube, the experimental group was treated with CBP therapy. The control group dealt with conventional anti-inflammatory, oxygen inhalation and other treatments only. Compared and analyzed in terms of alterations in blood inflammatory factors, cardiac function, BNP prior to and after therapy, blood pressure, blood WBC recovery time, and so on.
TNF-a, CRP, and PCT levels in the control and experimental groups were substantially more prominent than the average reference value prior to treatment. They decreased considerably at distinct time points after therapy, with substantial distinctions (p< 0.05). A more meaningful decrease was noticed in the experimental group in comparison with the control group (p< 0.05). BNP and cardiac function were improved in both groups prior to and after therapy, and the amelioration of indexes in the experimental group was more substantial than that in the control group after therapy, with statistically considerable distinctions. The improvement time in experimental group was earlier than in the control group, with statistically substantial differences.
Patients with urosepsis complicated with heart failure after indwelling DJ tube have their inflammatory factors improved significantly, with more thorough excretion by using conventional treatment combined with CBP therapy.
探讨连续性血液净化（CBP）在输尿管结石致尿脓毒症并导尿后心力衰竭患者中的应用价值。
本研究为临床对比研究。选取2021年1月至2023年3月在河北大学附属医院收治的60例输尿管结石合并心力衰竭及尿脓毒症患者，随机分为对照组和试验组（n = 30）。试验组在留置DJ管后给予常规治疗的基础上，采用CBP治疗；对照组仅给予常规抗炎、吸氧等治疗。比较并分析两组治疗前后血液炎症因子、心功能、脑钠肽（BNP）、血压、血白细胞恢复时间等指标的变化。
治疗前，对照组和试验组的肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）和降钙素原（PCT）水平均显著高于平均参考值。治疗后不同时间点，这些指标均显著下降，且两组间差异有统计学意义（p < 0.05）。试验组较对照组下降更显著（p < 0.05）。两组治疗前后BNP和心功能均有所改善，试验组治疗后各指标改善程度较对照组更显著，差异有统计学意义。试验组改善时间早于对照组，差异有统计学意义。
留置DJ管后并发心力衰竭的尿脓毒症患者，采用常规治疗联合CBP治疗可显著改善炎症因子水平，促进排泄更彻底。
