连续性血液净化对感染性休克致多器官功能衰竭的疗效观察

Effect of continuous blood purification on multiple organ failure caused by septic shock

目的分析连续性血液净化治疗感染性休克致多器官功能衰竭的临床效果。方法选取2018—2019年山西医科大学第二医院重症医学科收治的86例感染性休克致多器官功能衰竭的患者,按照随机数字表法分成对照组和观察组,各43例。给予对照组行常规治疗,观察组在常规治疗基础上加用连续性血液净化治疗,比较2组生化和血气指标、急性生理和慢性健康状况评价(APACHE)-Ⅱ评分和脓毒症相关性器官功能衰竭评价(SOFA)评分及预后情况。结果治疗后,观察组尿素氮、肌酐、肌酸激酶同工酶(CK-MB)、血总胆红素、丙氨酸转氨酶均低于对照组;观察组氧合指数高于对照组;观察组APACHE-Ⅱ评分及SOFA评分低于对照组;观察组重症监护病房(ICU)内病死率低于对照组;观察组各项指标均明显优于对照组,差异有统计学意义(P<0.05)。结论连续性血液净化对感染性休克致多器官功能衰竭的治疗作用明显,可有效减轻器官功能衰竭,改善预后。

Objective To investigate the clinical effect of continuous blood purification(CBP)on multiple organ dysfunction syndrome(MODS)caused by septic shock.Methods A total of 86 patients with MODS caused by septic shock admitted to the Department of Critical Care Medicine of Second Hospital of Shanxi Medical University between 2018 and 2019 were included in this study and divided into the control group and the study group(n=43 each)according to random number table.The control group was given routine treatment,and the study group was giv-en CBP in addition to routine treatment.The biochemical and blood gas indexes,APACHE-Ⅱscore,SOFA score and prognosis were compared between the two groups.Results After treatment,the blood urea nitrogen,serum creatinine,CK-MB,total blood bilirubin,and alanine aminotransferase in the study group were lower than those in the control group,and the oxygenation index in the study group was higher than that in the control group.The APACHE-Ⅱand SOFA scores in the study group were lower than those in the control group.The ICU mortality in the study group was lower than that in the control group.All these indexes in the study group were significantly favorable than those in the control group,with significant differences(P<0.05).Conclusion Continuous blood purification offers evidenced therapeutic effect on MODS caused by septic shock,with effective improvements in organ failure and prognosis.