早期高容量血液滤过对重症脓毒血症患者的临床疗效  

Clinical Efficacy of Early High-volume Hemofiltration in Patients with Severe Sepsis

作　　者：亢翠翠[1] 张保军[1] 邹秀丽[1] KANG Cuicui;ZHANG Baojun;ZOU Xiui(Department of Critical Care Medicine,Liaocheng People's Hospital,Liaocheng,Shandong Province,252000 China)

机构地区：[1]山东省聊城市人民医院重症医学科,山东聊城252000

出　　处：《系统医学》2023年第1期65-69,共5页Systems Medicine

基　　金：山东省病理生理学会科研课题(2021BS005)。

摘　　要：目的分析将早期高容量血液滤过疗法应用到重症脓毒血症患者中的临床效果。方法选取2019年4月—2021年4月期间山东省聊城市人民医院ICU收治的90例重症脓毒血症患者作为研究对象,按照入院顺序分为两组。对照组45例实施常规治疗,观察组45例在此基础上添加早期高容量血液滤过疗法,分析两组治疗前后炎症水平、血流动力学、SOFA及APACHEⅡ评分、脏器功能情况。结果治疗前,两组炎症水平指标和血流动力学、SOFA、APACHEⅡ评分比较,差异无统计学意义(P>0.05)。治疗后,观察组的炎症水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后,观察组的SOFA评分(6.47±1.82)分以及APACHEⅡ评分(10.18±3.18)分均优于对照组的(7.99±1.94)分、(14.75±3.26)分,差异有统计学意义(t=3.833、6.731,P<0.05);治疗后,观察组的血流动力学指标MAP、CO均高于对照组,HR低于对照组,差异有统计学意义(P<0.05)。结论在重症脓毒血症的治疗上实施早期高容量血液滤过疗法,可以降低SOFA评分,整体疗效确切,在临床上值得推荐。Objective To analyze the clinical effect of applying early high-volume hemofiltration therapy to patients with severe sepsis.Methods 90 patients with severe sepsis admitted to the ICU of Liaocheng People's Hospital in Shandong Province from April 2019 to April 2021 were selected as the study subjects.They were divided into two groups according to the order of admission.The control group received routine treatment with 45 cases,while the ob⁃servation group received early high-volume hemofiltration therapy with 45 cases.The inflammation level,hemodynam⁃ics,SOFA and APACHEⅡscores,and organ function of the two groups before and after treatment were analyzed.Results Before treatment,there was no statistically significant difference between the two groups in the level of inflam⁃mation,hemodynamics,SOFA and APACHEⅡscores(P>0.05).After treatment,the level of inflammation in the ob⁃servation group was significantly lower than that in the control group the difference was statistically significant(P<0.05).After treatment,the SOFA score(6.47±1.82)points and APACHEⅡscore(10.18±3.18)points of the observa⁃tion group were better than that those of the control group(7.99±1.94)points and(14.75±3.26)points,the difference was statistically significant(t=3.833,6.731,P<0.05);the hemodynamic indexes MAP and CO in the observation group were higher than those in the control group,and HR was ower than bett that in the control group,the difference was statistically significant(P<0.05).Conclusion The implementation of early high-volume hemofiltration therapy in the treatment of severe sepsis can reduce the SOFA score with definite overall efficacy and is recommended in clinical practice.

关 键 词：早期高容量血液滤过 脓毒血症 血流动力学 临床疗效 

分 类 号：R459.7[医药卫生—急诊医学]