早期连续血液滤过对重症脓毒症患者影响的临床研究  

Clinical Study on the Effect of Early Continuous Hemofiltration on Patients with Severe Sepsis

作　　者：莫诗瑶 赖敏 MO Shi-yao;LAI Min(Hemodialysis Room,Shenzhen Hengsheng Hospital,Shenzhen,Guangdong Province,518102 China;Department of Respiratory Medicine,Shenzhen Hengsheng Hospital,Shenzhen,Guangdong,518102 China)

机构地区：[1]深圳恒生医院血透室,广东深圳518102 [2]深圳恒生医院呼吸内科,广东深圳518102

出　　处：《中外医疗》2020年第9期37-38,41,共3页China & Foreign Medical Treatment

摘　　要：目的探讨重症脓毒症患者采用早期连续血液滤过治疗的临床疗效。方法于2015年12月—2017年12月方便选择该院脓毒症患者共60例,对照组(n=30)采用常规支持治疗,观察组(n=30)结合早期连续血液滤过治疗,采用酶联免疫吸附实验(ELISA)检测治疗前及治疗72 h后观察炎症指标:IL-6、IL-10、CRP、TNF-α,观察患者的内毒素水平;检测两组患者的心率(HR)、MAP、氧合指数、分析APACHEⅡ的变化。结果治疗后观察组的IL-6(130.07±34.05)pg/mL、IL-10(50.01±21.03)pg/mL、CRP(29.86±11.07)mg/L、TNF-α(150.01±12.23)μg/L和内毒素水平(0.64±0.10)Eu/mL、APACHE II评分(12.10±1.30)分较对照组对应值(201.12±123.03)pg/mL、(78.61±21.01)pg/mL、(61.13±18.52)mg/L、(253.10±25.67)μg/L、(2.86±1.06)Eu/mL、(21.03±2.84)分下降更为明显,氧合指数(346.89±15.25)较对照组对应值(256.97±12.41)出现升高(P<0.05)。结论重症脓毒症患者采用早期连续血液滤过治疗可有效的降低炎症因子水平,维持了机体血流动力学稳定。Objective To investigate the clinical efficacy of early continuous hemofiltration in patients with severe sepsis.Methods A total of 60 patients with sepsis in the hospital from December 2015 to December 2017 were convenient selected.The control group(n=30)was treated with conventional support.The observation group(n=30)combined with early continuous hemofiltration,and the enzyme-linked immunosorbent assay(ELISA)was used to detect the treatment.After 72 h of treatment,the indicators of inflammation were observed:IL-6,IL-10,CRP,TNF-α,and the endotoxin level was observed.The heart rate(HR),MAP,oxygenation index and APACHE II of the two groups were measured.Results IL-6(130.07±34.05)pg/mL,IL-10(50.01±21.03)pg/mL,CRP(29.86±11.07)mg/L,TNF-α(150.01±12.23)μg/L in the observation group after treatment.The level of endotoxin(0.64±0.10)Eu/mL and APACHE II score(12.10±1.30)points was higher than that of the control group(201.12±123.03)pg/mL,(78.61±21.01)pg/mL,(61.13±18.52)mg/L,(253.10±25.67)μg/L,(2.86±1.06)Eu/mL,(21.03±2.84)points were more obvious,and the oxygenation index(346.89±15.25)was higher than the control group(256.97±12.41)increased(P<0.05).Conclusion Early continuous hemofiltration in patients with severe sepsis can effectively reduce the level of inflammatory factors and maintain the hemodynamic stability of the body.

关 键 词：脓毒症 早期连续血液滤过 临床研究 

分 类 号：R459.7[医药卫生—急诊医学]