Study On The Treatment Of Acute Respiratory Distress Syndrome Of Patients With Continuous Renal Replacement

Objective:The study focuses on the application of continuous renal replacement therapy (CRRT) prognosis of patients with acute respiratory distress syndrome (ARDS)Methods:Retrospective analysis 30 cases of ARDS patients in Affiliated Hospital of Yanbian University from January 2012 to January 2015.Among them,15 patients with conventional treatment as control group for A group, treaded mechanical ventilation, anti infection,application Human Albumin, hormone, diuretic, electrolyte, acid-base balance and protect the viscera function disorder.15 cases as experimental group is B group, treatment with CRRT on the basis of the conventional treatments. Dynamic monitoring of APACHn scores of the two groups,comparison of the two groups of patients before treatment (0h), and each treatment point arterial blood pH, oxygenation index (PaO2/ FiO2), lactate (Lac), blood routine and blood biochemistry examination,and compare mechanical ventilation time, ICU stay time, mortalityand whether suffering from ventilator associated pneumonia (VAP) developed.Results:1. Before treatment, A, B two groups in age and APACHEII score had no statistical difference (P>0.05), two groups of APACHEII scores after treatment has certain degree of decline, and group B patients’ APACHEHII scores significantly decreased, at the same time point compared with group A (P<0.05);2. Each observation point in the process of treatment, before treatment (0h)PaO2/FiO2 has no obvious difference between the two groups, after 12 hours treatment,group B (CRRT treatment group) PaO2/FiO2 improve more apparent compared with group A, the rest of the time have no the difference (P<0.05). A, B group of pH, Lac have no significant difference;3. Before treatment (0h), the two groups in the main indicators of blood white cell count (WBC), neutrophil cell percentage (neut) and platelet (PLT) and C reflect protein (CRP) had no significant difference (P> 0.05), after 24hours for the treatment WBC and CRP of group B decreased significantly (P< 0.05);4. Group B after 12h,24h,48h treatment blood urea nitrogen and serum creatinine were significantly decreased than the same treatment observation points in group A (P< 0.05), but the alanine aminotransferase and aspartate aminotransferase no obvious difference (P>0.05);5. There was no statistically significant difference between Group A and group B patients in clinical prognosis and outcome.Conclusion:1. The application of CRRT in the treatment of acute respiratory distress syndrome (ARDS) can reduce the APACHE II,CRRT can improve the risk of death; 2. The improvement of PaO2/FiO2 after 12 hours treatment was obviously improved by CRRT,CRRT can improve the oxygenation of the body;3. After 24h CRRT treatment B group patients’ WBC and CRP were significantly decreased,CRRT can remove the body inflammatory mediators, reduce the level of infection;4. The improvement of urea nitrogen and creatinine was obviously improved by CRRT,CRRT can improve renal function.