间歇性高容量血液滤过感染性休克患者血流动力学及序贯器官衰竭评分的影响  

Influence of Hemodynamics and Sequential Organ Failure Score in Patients with Intermittent High Volume Hemofiltration Septic Shock

作　　者：刘德海[1] LIU Dehai(Jiamusi Central Hospital,Jiamusi 154002,China)

机构地区：[1]黑龙江省佳木斯市中心医院,黑龙江佳木斯154002

出　　处：《中国医学创新》2021年第4期77-80,共4页Medical Innovation of China

摘　　要：目的:探讨间歇性高容量血液滤过感染性休克患者血流动力学及序贯器官衰竭评分的影响。方法:回顾性分析2018年4月-2019年4月本院收治的83例感染性休克患者的临床资料,将接受常规液体复苏治疗的40例患者纳入对照组,接受间歇性高容量血液滤过治疗的43例患者纳入观察组。观察两组患者治疗前后心功能指标、炎性因子水平、血流动力学指标及氧交换指标变化情况。结果:治疗后,两组IL-6、PCT、NT-proBNP水平均降低,且观察组的IL-6、PCT、NT-proBNP水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组的ITBVI、EVLWI、PVPI水平均较治疗前降低,且观察组各项水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组的P(A-a)O_(2)、Lac水平均较对照组低,而PaO_(2)/FiO_(2)较对照组高,差异均有统计学意义(P<0.05)。治疗后,观察组的APACHEⅡ、SOFA评分均较对照组低,差异均有统计学意义(P<0.05)。结论:间歇性高容量血液滤过应用于感染性休克患者中,可降低其炎症因子水平以及血管外肺水指数,且能够稳定患者血流动力学指标,降低序贯器官衰竭评分。Objective:To investigate the influence of hemodynamics and sequential organ failure score in patients with septic shock.Method:The clinical data of 83 patients with septic shock admitted to our hospital from April 2018 to April 2019 were analyzed retrospectively.40 patients receiving conventional fluid resuscitation were included in the control group,43 patients receiving intermittent high volume hemofiltration were included in the observation group.The changes of cardiac function index,inflammatory factor level,hemodynamic index and oxygen exchange index were observed before and after treatment.Result:After treatment,IL-6,PCT and NT-proBNP levels were decreased in both groups,the levels of IL-6,PCT and NT-proBNP in the observation group were all lower than those in the control group,the differences were statistical significance(P<0.05).After treatment,the levels of ITBVI,EVLWI and PVPI in both groups were lower than before treatment,all levels in the observation group were lower than the control group,the differences were statistical significance(P<0.05).After treatment,the levels of P(A-a)O_(2) and Lac in the observation group were lower than those in the control group,while the levels of PaO_(2)/FiO_(2) were higher than those in the control group,the differences were statistical significance(P<0.05).After treatment,the observation group of APACHEⅡand SOFA scores were lower than those in the control group,the differences were statistical significance(P<0.05).Conclusion:The application of intermittent high volume hemofiltration in septic shock patients can reduce the level of inflammatory factors and the index of extravascular pulmonary water,stabilize the hemodynamic indexes and reduce the score of sequential organ failure.

关 键 词：间歇性高容量血液滤过 感染性休克 血流动力学 序贯器官衰竭评分 

分 类 号：R459.7[医药卫生—急诊医学]