PHVHF联合HP治疗脓毒性休克并发肾损伤患者的效果  

The Effect of PHVHF Combined with HP in the Treatment of Patients with Septic Shock Complicated by Renal Injury

作　　者：黄汉东[1] 陈碧碧[1] 唐德志[1] 陈盛标 HUANG Handong;CHEN Bibi;TANG Dezhi;CHEN Shengbiao(Emergency Department,Affiliated Hospital of Putian University,Putian,Fujian Province,351100 China)

机构地区：[1]莆田学院附属医院急诊科,福建莆田351100

出　　处：《中外医疗》2021年第35期59-62,共4页China & Foreign Medical Treatment

摘　　要：目的探讨脉冲式高容量血液滤过(PHVHF)联合血液灌流(HP)治疗脓毒性休克并发肾损伤患者的效果。方法随机选取2018年2月—2021年3月该院收治的脓毒性休克并发肾损伤患者60例,按计算机随机数字法分为研究组和对照组,各30例。对照组应用PHVHF治疗,研究组在对照组基础上联合HP治疗,观察两组患者血液炎症因子、肾功能恢复情况及预后情况。结果两组治疗72 h后白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、降钙素原(PCT)、肌酐、乳酸对比均下降,且研究组低于对照组,差异有统计学意义(P<0.05);两组患者治疗72 h后急性生理与慢性健康(APACHE)Ⅱ、序贯器官衰竭(SOFA)评分均降低,且研究组低于对照组,差异有统计学意义(t=5.169、2.848,P<0.05)。结论PHVHF联合HP治疗脓毒性休克并发肾损伤患者,可降低机体炎症,改善肾功能,促进患者恢复。Objective To investigate the effect of pulse high volume hemofiltration(PHVHF)combined with hemoperfusion(HP)in the treatment of patients with septic shock complicated by renal injury.Methods A total of 60 patients with septic shock and renal injury who were admitted to the hospital from February 2018 to March 2021 were randomly selected.According to the computer random number method,they were divided into the study group and the control group,each with 30 cases.The control group was treated with PHVHF,and the study group was combined with HP treatment on the basis of the control group.Observe the blood inflammatory factors,renal function recovery and prognosis of the two groups of patients.Results The contrast of interleukin 6(IL-6),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),procalcitonin(PCT),creatinine,and lactate decreased after 72 h of treatment in the two groups,and the study group was lower than the control group,the difference was statistically significant(P<0.05).The acute physiology and chronic health(APACHE)Ⅱand sequential organ failure(SOFA)scores of the two groups of patients decreased after 72 h of treatment,and the study group was lower than the control group,the difference was statistically significant(t=5.169,2.848,P<0.05).Conclusion PHVHF combined with HP in the treatment of patients with septic shock complicated by renal injury can reduce body inflammation,improve renal function,and promote the recovery of patients.

关 键 词：脉冲式高容量血液滤过 脓毒性休克 血液灌流 肾损伤 连续血液滤过 

分 类 号：R459[医药卫生—治疗学]