CVVH与CVVHDF治疗脓毒症休克伴多脏器功能损害患者的临床效果  

Clinical Efficacy of CVVH and CVVHDF in the Treatment of Septic Shock Patients with Multiple Organ Dysfunction

作　　者：尧娟[1] 朱俊臣[1] 秦晓明 刘国明 李卉[1] YAO Juan;ZHU Junchen;QIN Xiaoming;LIU Guoming;LI Hui(Affiliated Hospital of Chengdu University,Chengdu 610106,China;不详)

机构地区：[1]成都大学附属医院,四川成都610106

出　　处：《中外医学研究》2023年第16期33-36,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨连续性静脉-静脉血液滤过(CVVH)与连续性静脉-静脉血液透析滤过(CVVHDF)治疗脓毒症休克伴多脏器功能损害患者的效果。方法:回顾性分析2019年1月—2022年6月成都大学附属医院收治的103例脓毒症休克伴多脏器功能损害患者的临床资料。根据不同的血液净化方法将其分为对照组(n=50)和观察组(n=53)。两组均给予常规综合治疗。对照组给予CVVH治疗,观察组给予CVVHDF治疗。比较两组净化前及净化7 d后的相关指标、炎症因子、免疫功能。结果:净化7 d后,观察组平均动脉压(MAP)高于对照组,心率、急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分、多器官功能障碍综合征(MODS)评分均低于对照组,差异有统计学意义(P<0.05)。净化7 d后,观察组白细胞介素-8(IL-8)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均低于对照组,差异有统计学意义(P<0.05)。净化7 d后,观察组免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)均高于对照组,差异有统计学意义(P<0.05)。结论:针对脓毒症休克伴多脏器功能损害患者,采用CVVHDF治疗体现出更为明显的效果,可以改善患者的生命体征,降低血清炎症因子水平,提升免疫力。Objective:To explore the efficacy of continuous veno-venous hemofiltration(CVVH)and continuous veno-venous hemodiafiltration(CVVHDF)in the treatment of septic shock patients with multiple organ dysfunction.Method:The clinical data of 103 patients with septic shock with multiple organ dysfunction admitted to the Affiliated Hospital of Chengdu University from January 2019 to June 2022 were retrospectively analyzed.According to different blood purification methods,they were divided into control group(n=50)and observation group(n=53).Both groups were given conventional comprehensive treatment.The control group was treated with CVVH,and the observation group was treated with CVVHDF.The related indexes,inflammatory factors and immune function before and after 7 d of purification were compared between the two groups.Result:After 7 d of purification,the mean arterial pressure(MAP)of the observation group was higher than that of the control group,and the heart rate,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and multiple organ dysfunction syndrome(MODS)score of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After 7 d of purification,the levels of interleukin-8(IL-8),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After 7 d of purification,the immunoglobulin G(IgG),immunoglobulin M(IgM)and immunoglobulin A(IgA)in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:For septic shock patients with multiple organ dysfunction,the treatment of CVVHDF shows more obvious effects,which can improve the vital signs of patients,reduce the level of serum inflammatory factors,and enhance immunity.

关 键 词：连续性静脉-静脉血液滤过 连续性静脉-静脉血液透析滤过 脓毒症休克 多脏器功能损害 

分 类 号：R459.7[医药卫生—急诊医学]