持续性血液滤过对中毒性休克合并急性呼吸窘迫综合征患者的预后以及28 d生存率分析  

Analysis of the Prognosis and 28-day Survival Rate of Continuous Hemofiltration in Patients with Toxic Shock and Acute Respiratory Distress Syndrome

作　　者：李江平[1] 王梅华[1] LI Jiangping;WANG Meihua(Emergency Department,Anxi County Hospital of Fujian Province,Quanzhou,Fujian,362400,China)

机构地区：[1]福建省安溪县医院急诊科,福建泉州362400

出　　处：《中外医疗》2024年第29期63-66,共4页China & Foreign Medical Treatment

摘　　要：目的探究中毒性休克合并急性呼吸窘迫综合征患者使用持续性血液滤过的治疗效果及对其28 d生存率的影响。方法回顾性选取2018年5月—2023年5月福建省安溪县医院收治的80例中毒性休克合并急性呼吸窘迫综合征患者的临床资料,根据治疗方案不同分为两组,每组40例,对照组开展常规治疗+有创通气,观察组开展常规治疗+持续性血液滤过治疗。比较两组的呼吸功能、血流动力学、预后效果及28 d生存率。结果治疗前,两组氧合指数[血氧分压/吸入氧浓度(partial pressure of oxygen/fraction of inspiration oxygen,PaO_(2)/FiO_(2))]、呼气末正压(positive end-expiratory pressure,PEEP)及pH比较,差异无统计学意义(P均>0.05);治疗后,两组pH比较,差异无统计学意义(P>0.05),观察组PaO_(2)/FIO_(2)高于对照组,PEEP低于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组的心指数(cardiac index,CI)、全身血管阻力指数(systemic vascular resistance index,SVRI)高于对照组,血乳酸(lactic acid,LAC)、去甲肾上腺素(noradrenaline,NE)低于对照组,差异有统计学意义(P均<0.05)。观察组的预后良好率高于对照组,差异有统计学意义(P<0.05)。观察组的28 d生存率为95.00%(38/40),高于对照组80.00%(32/40),差异有统计学意义(χ^(2)=4.114,P<0.05)。结论中毒性休克合并急性呼吸窘迫综合征患者辅助持续性血液滤过,可以稳定血流动力学,改善呼吸功能,预后良好,28 d生存率高。Objective To explore the therapeutic effect of continuous hemofiltration on toxic shock and acute respira⁃tory distress syndrome and the effect of 28 days survival rate.Methods The clinical data of 80 patients with toxic shock and acute respiratory distress syndrome admitted to Anxi County Hospital of Fujian Province from May 2018 to May 2023 were retrospectively selected and divided into two groups according to different treatment schemes,with 40 cases in each group.The control group was treated with routine treatment+invasive ventilation,and the observation group was treated with routine treatment+continuous hemofiltration.The respiratory function,hemodynamics,progno⁃sis and 28-day survival rate of the two groups were compared.Results Before treatment,there was no significant dif⁃ference in Oxygenation index[partial pressure of oxygen/fraction of inspiration oxygen(PaO_(2)/FiO_(2))].positive endexpiratory pressure(PEEP)and pH between the two groups(all P>0.05);after treatment,there was no significant dif⁃ference in pH(P>0.05),PaO_(2)/FIO_(2) in the observation group was higher than that in the control group,and PEEP was lower than that in the control group,the differences were statistically significant(all P<0.05);after treatment,The car⁃diac index(CI)and systemic vascular resistance index(SVRI)in the observation group were higher than those in the control group,and the blood lactic acid(LAC)and noradrenaline(NE)were lower than those in the control group,the differences were statistically significant(all P<0.05).The good prognosis rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The 28-day survival rate of the ob⁃servation group was 95.00%(38/40),which was higher than that of the control group 80.00%(32/40),and the differ⁃ence was statistically significant(χ^(2)=4.114,P<0.05).Conclusion Continuous hemofiltration can stabilize hemodynam⁃ics and improve respiratory function in patients with toxic shock and acute respi

关 键 词：中毒性休克 急性呼吸窘迫综合征 持续性血液滤过 预后 28 d生存率 

分 类 号：R459.7[医药卫生—急诊医学]