高容量血液滤过联合常规液体复苏治疗重症感染性休克患者的效果分析  

Effect Analysis of High-volume Hemofiltration Combined with Routine Fluid Resuscitation in Treatment of Severe Septic Shock Patients

作　　者：冒秀宏[1] 崔琰[2] 汪涛 许伟伟 陈少波 MAO Xiuhong;CUI Yan;WANG Tao;XU Weiwei;CHEN Shaobo(ICU Department,Dongtai City People's Hospital,Dongtai,Jiangsu 224200;Department of Orthopaedics,Second Ward,Dongtai City People's Hospital,Dongtai,Jiangsu 224200)

机构地区：[1]东台市人民医院重症医学科,江苏东台224200 [2]东台市人民医院骨科二病区,江苏东台224200

出　　处：《智慧健康》2023年第20期188-191,共4页Smart Healthcare

摘　　要：目的 探讨重症感染性休克患者采用高容量血液滤过(HVHF)联合常规液体复苏治疗的效果。方法本次报告时间区间为2020年1月-2022年9月,选取的62例调查对象均是本院收治的重症感染性休克患者,进行回顾性分析,根据治疗方案不同分为常规组(31)和研究组(31),前者以常规液体复苏治疗为主,后者在常规液体复苏治疗后6h内给予高容量血液滤过治疗,分析治疗效果。结果 治疗后,研究组患者器官功能障碍综合征(MODS)、急性生理与慢性生理健康状态(APACHE-Ⅱ)评分均更低(P<0.05);治疗后,研究组ICU住院时间、总住院时间均更短(P<0.05);治疗后,研究组SCr、ALT、TBiL水平、外周血CD8^(+)百分比均更低,研究组CD4^(+)/CD8^(+)值、PaO_(2)、OI水平、外周血CD4^(+)百分比均更高(P<0.05)。结论 重症感染性休克患者应用HVHF联合常规液体复苏治疗的效果显著,可有效改善患者血流动力学指标,提升患者免疫功能,缩减住院时间,值得推广。Objective To investigate effect of high volume hemofiltration(HVHF)combined with routine fluid resuscitation in treatment of severe septic shock patients.Methods The report covered period from January 2020 to September 2022,reviewed and analyzed 62 patients with severe septic shock admitted to our hospital and divided them into two groups:routine group(31)and study group(31).the former was mainly treated with routine liquid resuscitation therapy,while the latter with high-volume hemofiltration treatment within 6 hours after routine liquid resuscitation therapy.Treatment effect was analyzed between two groups.Results After treatment,study group had lower scores of organ dysfunction syndrome(MODS),acute physiological and chronic physiological health status(APACHE-Ⅱ),P<0.05.After treatment,ICU length of stay and total length of stay in study group was shorter,P<0.05.After treatment,levels of SCr,ALT,TBiL and peripheral blood CD8^(+)percentage were lower in study group,while CD4/CD8^(+)ratio,PaO_(2),OI levels and peripheral blood CD^(4)+percentage were higher in study group(P<0.05).Conclusion HVHF combined with routine liquid resuscitation can achieve significant effect for patients with severe septic shock,can improve hemodynamic indicators,enhance immune function,reduce length of stay effectively,which is worthy of promotion.

关 键 词：重症感染性休克 常规液体复苏治疗 高容量血液滤过 免疫功能 

分 类 号：R459.7[医药卫生—急诊医学]