高容量血液滤过治疗重症感染性休克的疗效观察

Curative effect of high volume hemofiltration in the treatment of severe septic shock

目的探讨高容量血液滤过对重症感染性休克患者的疗效。方法36例重症感染性休克患者随机分为对照组（18例）和治疗组（18例），对照组予以常规治疗，治疗组在常规治疗的基础上加用高容量血液滤过治疗，比较两组患者治疗前后呼吸、血流动力学、血气指标、炎症因子以及APACHEII变化。结果两组患者治疗后呼吸、血气指标、炎症因子以及APACHEII指标均有改善（P〈0．05）；治疗组改善更为明显（P〈0．05），且治疗组治疗起效时间明显提前。结论高容量血液滤过能改善重症感染性休克患者呼吸、血流动力学指标，降低动脉血乳酸、炎症介质水平及APACHEII评分，改善患者预后。

Objective To observe the efficacy of high volume hemofihration （HVHF） in the treatment of severe septic shock. Methods A total of 36 patients with severe septic shock were divided into treatment group and control group （n= 18 each）. All patients received volume resuscitation, vasopressor drug, early antibiotic administration, and other treatments. Patients in the treatment group received HVHF for 72 h simultaneously. Results The parameters of respiratory and hemodynamic function, the blood gas analysis, systemic inflammation and APACHE II were improved after the treatment in two groups （P 〈0.05）. Compared with the control group, the levels of above parameters were significantly improved in the treatment group （P 〈0.05）. In addition, the initial effective time of the treatment group was significantly earlier. Conclusion HVHF can significantly improve the prognosis of patients with severe septic shock through alleviating respiratory-circulation failure, reducing blood lactic acid and systemic inflammation as well as APACHEII scores.