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目的 :观察远程会诊在多器官功能障碍综合征患者中的应用效果。方法 :取多器官功能障碍综合征患者90例,采用随机数字方法分为对照组(n=45)和观察组(n=45)。对照组采用常规方案治疗,观察组在对照组基础上联合远程会诊方案治疗,采用双抗体夹心免疫吸附法测定2组治疗前、后血清TNF-α、IL-1、IL-6水平,测定2组患者治疗前、后APACHEII评分、平均动脉压(MAP)及血乳酸(Lac)水平,比较2组临床疗效及对炎症因子及心功能等指标。结果 :2组患者治疗前血清TNF-α、IL-1、IL-6水平比较差异无统计学意义(P>0.05);观察组治疗后血清TNF-α、IL-1、IL-6水平,低于对照组(P<0.05);2组治疗前APACHEII评分、MAP及Lac水平比较差异无统计学意义(P>0.05);观察组治疗后APACHEII评分及Lac水平,低于对照组(P<0.05);观察组治疗后MAP水平,高于对照组(P<0.05);观察组治疗后存活率为91.11%,对照组为80.00%,2组存活率比较差异有统计学意义(P<0.05)。结论 :多器官功能障碍综合征患者在常规方案基础上联合远程会诊方案治疗效果理想,能降低机体炎症因子,改善患者心功能指标,值得推广应用。
Objective: To observe the effect of remote consultation in patients with multiple organ dysfunction syndrome. Methods: 90 patients with multiple organ dysfunction syndrome were divided into control group (n = 45) and observation group (n = 45) by random number method. The control group was treated with conventional regimen. The observation group was treated with the remote consultation program on the basis of the control group. The levels of TNF-α, IL-1 and IL-6 in the two groups before and after treatment were measured by double antibody sandwich immunoadsorbent assay. APACHEII score, mean arterial pressure (MAP) and lactic acid (Lac) level before and after treatment were compared between the two groups. The clinical curative effect, inflammatory factors and cardiac function were compared between the two groups. Results: The serum levels of TNF-α, IL-1 and IL-6 in two groups had no significant difference before treatment (P> 0.05). The levels of TNF-α, IL-1 and IL- (P <0.05). There was no significant difference in APACHEII score, MAP and Lac levels between the two groups before treatment (P> 0.05). APACHEII score and Lac level in the observation group after treatment were lower than those in the control group (P < 0.05). The MAP level in the observation group was higher than that in the control group (P <0.05). The survival rate of the observation group after treatment was 91.11% and that of the control group was 80.00%, the difference was statistically significant (P <0.05 ). CONCLUSIONS: Patients with multiple organ dysfunction syndrome, combined with long-term consultation programs on the basis of routine programs, are effective in reducing the body’s inflammatory cytokines and improving their cardiac function and are worth popularizing and applying.