血液净化CVVH模式对感染性休克患者炎性因子及血气分析的影响  

Effect of Blood Purification CVVH Mode on Inflammatory Factors and Blood Gas Analysis in Patients with Septic Shock

作　　者：王新会 胡淼 马晨博 Wang Xinhui;Hu Miao;Ma Chenbo(Intensive Care Medicine,Zhoukou Central Hospital,Zhoukou,Henan,466000,China)

机构地区：[1]周口市中心医院重症医学,河南周口466000

出　　处：《黑龙江医学》2025年第2期149-152,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨血液净化连续静脉-静脉血液滤过(CVVH)模式对感染性休克患者炎性因子及血气分析的影响。方法:回顾性分析2022年4月—2023年4月周口市中心医院收治的80例感染性休克患者临床资料,用不同治疗方法将其分为观察组(40例)和对照组(40例)。对照组给予呼吸支持、抗感染、纠正酸碱平衡失调、应用血管活性药物、补充血容量、营养支持及维持水电解质平衡等常规治疗,观察组在对照组的基础上联合血液净化CVVH模式治疗,治疗时间为4周。比较两组患者治疗预后炎性因子水平、血气分析变化、氧代谢指标及心律、平均动脉压水平。结果:观察组24 h去甲肾上腺素用量、24 h输液量较对照组少,机械通气时间(MV)、住院时间较对照组短,差异均有统计学意义(t=3.918、16.530、14.963、24.416,P<0.05);治疗后,观察组肿瘤坏死因子(TNF-α)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、C反应蛋白(CRP)、降钙素原(PCT)水平比对照组低,差异均有统计学意义(t=8.856、3.581、9.635、9.599、30.036,P<0.05);治疗后,观察组乳酸(Lac)水平比对照组低,碱剩余(BE)水平比对照组高,差异均有统计学意义(t=5.318、34.989,P<0.05);治疗后,观察组中心静脉血氧饱和度(ScvO2)水平比对照组高,氧耗指数(VO2 I)、脑氧摄取率(CEO2)水平比对照组低,差异均有统计学意义(t=2.863、9.558、6.202,P<0.05);治疗后,观察组的心率(HR)值明显低于对照组,平均动脉压(MAP)明显高于对照组,差异均有统计学意义(t=2.813、3.256,P<0.05)。结论:血液净化CVVH模式治疗感染性休克患者能够使临床救治效率得到良好提升,并降低患者机体炎症反应,改善患者血气指标及氧代谢指标,安全可靠。Objective:To explore the effect of blood purification Continuous venous blood filtration mode(CVVH)mode on blood gas analysis and clinical recovery related indicators in patients with septic shock.Methods:80 patients with septic shock who were admitted to the hospital from April 2022 to April 2023 were selected.They were divided into two groups using random number table method,with 40 patients in each group.The control group received routine treatment,while the observation group received blood purification CVVH mode treatment.The treatment prognosis,inflammatory factor levels,blood gas analysis changes,oxygen metabolism indicators,heart rhythm,and mean arterial pressure levels between the two groups were compared.Results:The 24 h norepinephrine dosage and 24 h infusion volume in the observation group were lower than those in the control group,and the mechanical ventilation(MV)time and hospitalization time were shorter than those in the control group,with statistically significant difference(t=3.918,16.530,14.963,24.416;P<0.05).After treatment,the levels of tumor necrosis factor(TNF-α),interleukin-10(IL-10),interleukin-6(IL-6),C-reactive protein(CRP)and procalcitonin(PCT)in observation group were lower than those in control group,and the difference was statistically significant(t=8.856,3.581,9.635,9.599,30.036;P<0.05).After treatment,the lactate(Lac)level in observation group was lower than that in control group,and the alkali residual(BE)level was higher than that in control group,with statistically significant difference(t=5.318,34.989;P<0.05).After treatment,the level of central venous oxygen saturation(ScvO2)in observation group was higher than that in control group,and the level of oxygen consumption index(VO2 I)and cerebral oxygen uptake rate(CEO2)in observation group was lower than that in control group,with statistically significant difference(t=2.863,9.558,6.202;P<0.05).After treatment,the heart rate(HR)of the observation group was significantly lower than that of the control group,and the mean arterial

关 键 词：感染性休克 连续静脉-静脉血液滤过模式 临床疗效 血气分析 

分 类 号：R541.64[医药卫生—心血管疾病]