高容量血液滤过对重症感染性休克患者脏器功能及动脉氧合指标的影响  

Effect of high volume hemofiltration on organ function and arterial oxygenation in patients with severe septic shock

作　　者：夏建光[1] 陈羽[1] 禹江涛[1] Xia Jianguang;Chen Yu;Yu Jiangtao(Department of ICU, Dezhou People’sHospital, Dezhou 253014, China)

机构地区：[1]山东省德州市人民医院ICU,253014

出　　处：《中国实用医刊》2019年第12期98-100,共3页Chinese Journal of Practical Medicine

摘　　要：目的观察高容量血液滤过(HVHF)对重症感染性休克患者脏器功能及动脉氧合指标的影响。方法回顾性分析2016年1月至2018年9月德州市人民医院治疗的137例重症感染性休克患者的临床资料,将接受常规液体复苏治疗的42例患者作为A组,将在液体复苏治疗6h后接受HVHF的45例患者作为B组,将在液体复苏治疗6h内接受HVHF的50例患者作为C组。观察三组治疗前后脏器功能指标[丙氨酸氨基转移酶(ALT)、血尿素氮(BUN)]及动脉氧合指标变化情况。结果治疗前A组、B、C组ALT、BUN、氧合指数比较,差异未见统计学意义(P>0.05)。治疗后与A组比较,B组、C组ALT、BUN较低,氧合指数较高,差异有统计学意义(P<0.05)。治疗后与B组比较,C组ALT、BUN较低,氧合指数较高,差异有统计学意义(P<0.05)。结论重症感染性休克患者接受HVHF治疗有助于改善动脉氧合指标,促进脏器功能恢复,而早期实施HVHF治疗效果更佳。Objective To observe the effect of high-volume hemofiltration (HVHF) on organ function and arterial oxygenation in patients with severe septic shock. Methods The clinical data of 137 patients with severe septic shock treated in Dezhou People’s Hospital from January 2016 to September 2018 were retrospectively analyzed. The 42 patients treated by conventional fluid resuscitation therapy were considered as group A, 45 patients treated by HVHF after 6 hours of fluid resuscitation therapy were considered as group B, and 50 patients treated by HVHF within 6 hours of fluid resuscitation therapy were considered as group C. The changes of functional indexes, including alanine transaminase (ALT), and blood urea nitrogen (BUN) and arterial oxygenation before and after treatment in the three groups were observed. Results There was no significant difference in the levels of ALT, BUN or oxygenation index among group A, group B and group C before treatment (P>0.05). After treatment, compared with group A, the levels of ALT and BUN were lower in group B and group C, and the oxygenation index was higher, and the differences were significant(P<0.05). After treatment, compared with group B, the levels of ALT and BUN were lower and oxygenation index was higher in group C, and the differences were significant (P<0.05). Conclusions HVHF treatment in patients with severe septic shock is conductive to improving arterial oxygenation index and promoting organ function recovery, and early HVHF treatment is more effective.

关 键 词：感染性休克 高容量血液滤过 脏器功能 动脉氧合指标 

分 类 号：R459.7[医药卫生—急诊医学]