血液灌流治疗急腹症合并感染性休克的疗效分析

Analysis on the effect of treating Acute abdomen combined Septic shock with hemoperfusion therapy

目的观察常规治疗基础联合血液灌流(HP)治疗急腹症导致感染性休克的疗效。方法将30例患者随机分为治疗组和对照组,各15例,治疗组采用常规治疗联合HP,对照组采用常规治疗。通过治疗后比较两组患者治疗前后的平均动脉压(MAP)、氧合指数(Pa O:/Fi Oz)、C一反应蛋白(CRP)、乳酸水平、降钙素原(PCT)、白细胞及心率,同时观察两组的住ICU天数、死亡率、不良反应及安全性。结果两组治疗后(MAP)、Pa O2/Fi O2、CRP、乳酸水平、PCT、白细胞、心率均较治疗前明显降低,差异有统计学意义;治疗组与对照组的死亡率分别为13.3%和40%,差异无统计学意义(P>0.05)。结论常规治疗联合HP治疗能更有效地清除炎症介质,改善感染性休克患者的预后,减低患者死亡率,缩短ICU住院时间,说明联合HP治疗急腹症感染性休克安全有效。

Objective To investigate the effect of the conventional treatment combined with hemoperfusion（ HP） in treating septic shock patients caused by acute abdomen. Methods 30 patients were randomly divided into treatment group and control group,15 cases in each group,patients in treatment group used the conventional treatment combined with hemoperfusion,and patients in control group used conventional therapy only. Mean arterial pressure（ MAP）,oxygenationindex（ Pa O / Fi Oz）,C reactive protein（ CRP）,lactic acid level,procalcitonin（ PCT）,white blood cell and heart rate were compared both at before and after the treatment between the two groups. ICU stay days,mortality,adverse reaction of treatment and the security were observed in the two groups. Results After treatment,the mean arterial pressure（ MAP）,oxygenation index（ Pa O2/ Fi O2）,c- reactive protein（ CRP）,lactic acid level,Procalcitonin（ PCT）,white blood cell and heart rate of the two groups were significantly decreased,the differences were statistically significant. The mortality of treatment group and the control group were 13. 3% and 40% respectively,the difference was not statistically significant（ P 0.05）. Conclusions The conventional treatment combined with HP therapy can effectively remove inflammatory mediators to improve the outcome in patients with septic shock,reduce the mortality of patients,short the duration of hospitalization in ICU,thus conventional treatmentcombined with HP in the treatment of septic shock caused by acute abdomen is safe and effective.