高容量血液滤过及血液灌流联合血浆置换在多器官功能障碍综合征患者中的使用价值

Application value of HVHF,hemoperfusion combined with plasma exchange in patients with MODS

目的:探讨高容量血液滤过(HVHF)、血液灌流联合血浆置换在多器官功能障碍综合征(MODS)患者中的使用价值。方法:2016年1月-2020年2月收治MODS患者60例,随机分为两组,各30例。两组均给予基础治疗;对照组加用HVHF治疗;研究组给予HVHF、血液灌流联合血浆置换。比较两组治疗效果。结果:研究组治疗48 h后凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)均低于对照组,差异有统计学意义(P<0.05);研究组治疗48 h后C反应蛋白(CRP)水平低于对照组,差异有统计学意义(P<0.05);研究组治疗2个月后序贯器官衰竭评估系统评分和慢性健康状况系统(APACHEⅡ)评分均低于对照组,差异有统计学意义(P<0.05)。结论:HVHF、血液灌流联合血浆置换可以改善MODS预后,降低体内炎性因子水平。

Objective:To explore the application value of HVHF,hemoperfusion combined with plasma exchange in patients with MODS.Methods:From January 2016 to February 2020,60 patients with MODS were selected and randomly divided into two groups with 30 cases in each group.Both groups were given basic treatment.The control group was treated with high volume hemofiltration.The study group was treated with HVHF,hemoperfusion and plasma exchange.We compared the treatment effect of the two groups.Results:In the study group,after 48 hours of treatment,PT,APTT and TT were lower than those in the control group,the difference was statistically significant(P<0.05).In the study group,after 48 hours of treatment,CRP level was lower than that in the control group,the difference was statistically significant(P<0.05).In the study group,after 2 months of treatment,the sequential organ failure assessment system score and ApacheⅡscore were lower than those in the control group,the difference was statistically significant(P<0.05).Conclusion:HVHF,hemoperfusion combined with plasma exchange can improve the prognosis of MODS and reduce the level of inflammatory factors.