严重脓毒症患者早期联合应用持续高容量血液滤过与血液灌流的临床疗效分析

Analysis of the Clinical Efficacy of the Early Combined Application of Continuous High-volume Hemofiltration and Hemoperfusion in Patients with Severe Sepsis

目的探讨严重脓毒症患者早期联合应用持续高容量血液滤过(CHVHF)与血液灌流(HP)的临床疗效。方法选取2019年2月—2020年2月该院收治的58例严重脓毒症(脓毒症休克)患者展开研究分析,根据患者住院床号的奇偶性与单组区间条件划分为对照组、研究组,每组29例。对照组院内开展CHVHF疗法,研究组院内开展CHVHF与HP疗法,比对分析两组患者治疗前后的血流动力学指标与预后效果。结果治疗前,两组血流动力学指标比较,差异无统计学意义(P>0.05);治疗后,研究组MAP(88±6)mmHg、CI(5.3±0.7)L/(min·m^(2))指标均高于对照组的(80±3)mmHg、(4.6±0.3)L/(min·m^(2)),差异有统计学意义(t=6.422、4.950,P<0.05);研究组患者的心血管活性药物使用时间(4.45±1.21)d、住ICU时间(21.34±6.02)d、机械通气时间(12.12±3.35)d均短于对照组的(8.34±2.65)、(33.10±7.13)、(19.98±6.75)d,差异有统计学意义(t=7.191、6.787、5.617,P<0.05)。结论严重脓毒症患者早期联合应用CHVHF与HP疗法,可改善血流动力学指标,有利于患者获取更好的预后质量。

Objective To explore the clinical effect of early combined application of continuous high volume hemofiltration(CHVHF)and hemoperfusion(HP)in patients with severe sepsis.Methods The 58 patients with severe sepsis(septic shock)admitted to the hospital from February 2019 to February 2020 were included for research and analysis.The patients were divided into control group and study group according to the parity of the hospital bed number and single-group interval conditions,29 cases in each group.The control group carried out CHVHF therapy in the hospital,and the study group carried out CHVHF and HP therapy in the hospital.The hemodynamic indexes and prognostic effects of the two groups of patients before and after treatment were compared and analyzed.Results Before treatment,the hemodynamic indexes of the two groups with out statistically significant difference(P>0.05).After treatment,MAP(88±6)mmHg and CI(5.3±0.7)L/(min·m^(2))in the study group were higher than(80±3)mmHg and(4.6±0.3)L/(min·m^(2))in the control group,with statistically significant differences(t=6.422,4.950,P<0.05).The duration of cardiovascular active drugs use(4.45±1.21)d,ICU stay(21.34±6.02)d and mechanical ventilation time(12.12±3.35)d in study group were shorter than those in control group(8.34±2.65)d,(33.10±7.13)d,(19.98±6.75)d.There were statistically significant differences(t=7.191,6.787,5.617,P<0.05).Conclusion The early combined application of CHVHF and HP therapy in patients with severe sepsis can improve hemodynamic indicators and help patients obtain better prognostic quality.