摘要
目的探讨高容量血液滤过治疗重症感染性休克的效果及对器官功能的改善作用。方法选择2017年1月~2020年10月宁德市闽东医院收治的168例重症感染性休克患者作为研究对象,采用随机数字表法将其分为A组、B组和C组,每组各56例。A组患者于液体复苏6 h内行高容量血液滤过治疗,B组患者于液体复苏6 h后行高容量血液滤过治疗,C组患者采用常规液体复苏治疗。比较三组患者治疗前后的器官功能情况、器官功能障碍综合征(MODS)评分、急性生理与慢性健康状况(A-PACHEⅡ)评分、血清炎症因子水平及ICU住院天数、总住院天数、28 d死亡率。结果治疗后,A组的丙氨酸氨基转移酶(ALT)、血尿素氮(BUN)低于B组、C组,A组的动脉氧合指数高于B组、C组,差异有统计学意义(P<0.05)。治疗后,A组的MODS评分、A-PACHEⅡ评分低于B组、C组,差异有统计学意义(P<0.05)。治疗后,A组的肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)低于B组、C组,差异有统计学意义(P<0.05)。A组患者ICU住院天数、总住院天数短于B组、C组,差异有统计学意义(P<0.05)。三组的28 d死亡率比较,差异无统计学意义(P>0.05)。结论早期行高容量血液滤过治疗重症感染性休克可促进器官功能改善,降低机体炎性反应,促进患者早日康复。
Objective To explore the effect of high volume hem of iltration in the treatment of severe septic shock and the improvement of organ function.Methods A total of 168 patients with severe septic shock admitted to Mindong Hospital of Ningde City were selected from January 2017 to October 2020 as research objects and divided into group A,group B and group C,with 56 cases in each group.Group A was treated with high volume hem of iltration under 6 hours of fluid resuscitation,group B was treated with high volume hem of iltration after 6 hours of fluid resuscitation,group C was treated with routine fluid resuscitation.The organ function,multiple organ dysfunction syndrome(MODS)score,acute physiology and chronic health evaluation(A-PACHEⅡ)score,serum levels of inflammatory factors before and after treatment and ICU hospitalization days,total hospitalization days,and 28 days mortality were compared among the three groups.Results After treatment,the alanine aminotransferase(ALT)and blood urea nitrogen(BUN)of group A were lower than those of group B and group C,and the arterial oxygenation index of group A was higher than that of group B and group C,the differences were statistically significant(P<0.05).After treatment,the MODS score and A-PACHEⅡscore of group A were lower than those of group B and group C,the differences were statistically significant(P<0.05).The levels of tumor necrosis factor-α(TNF-α)and C reactive protein(CRP)of group A were lower than those of group B and group C,the differences were statistically significant(P<0.05).ICU hospitalization days and total hospitalization days of group A were shorter than those in group B and group C,and the differences were statistically significant(P<0.05).There was no statistically significant difference of the 28 days mortality between the three groups(P>0.05).Conclusion Early high-volume hem of iltration to treat severe septic shock could promote the improvement of organ function,reduce the body′s inflammatory response,and promote the patient′s speedy recovery.
作者
龚振斌
施云弟
舒海林
顾凌
GONG Zhen-bin;SHI Yun-di;SHU Hai-lin;GU Ling(Department of Critical Care Medicine,Mindong Hospital of Ningde City,Fujian Province,Ningde 355000,China)
出处
《中国当代医药》
CAS
2021年第16期46-49,共4页
China Modern Medicine
关键词
高容量血液滤过
重症感染性休克
器官功能
器官功能障碍综合征评分
急性生理与慢性健康状况评分
血清炎症因子
High volume hemofiltration
Aevere septic shock
Organ function
Multiple organ dysfunction syndrome score
Acute physiology and chronic health evaluation score
Serum inflammatory factors
