参附注射液辅助连续性静脉-静脉血液滤过对重症脓毒血症患者血气指标和肾功能的影响

Effects of Shenfu Injection-assisted Continuous Veno-venous Hemofiltration on Blood Gas Indicators and Renal Function in Patients with Severe Sepsis

目的探究参附注射液辅助连续性静脉-静脉血液滤过(continuous veno-venous hemofil⁃tration,CVVH)治疗对重症脓毒血症患者血气指和肾功能的影响。方法方便选取2021年6月—2022年6月徐州医科大学附属医院重症医学科救治的104例伴急性肾衰竭的重症脓毒血症患者为研究对象,按照随机数表法分为研究组和对照组,各52例。对照组予以CVVH治疗,研究组在对照组的治疗基础上给予参附注射液进行干预。对比两组患者治疗前后的血气指标[氧分压(partial pressure of oxygen,PaO_(2))、二氧化碳分压(partial pressure of carbon dioxide,PaCO_(2))、氧合指数(partial pressure of oxygen/fraction of inspired oxygen,PaO_(2)/FiO_(2))]、肾功能指标[血肌酐(serum creatinine,Cr)、尿素氮(blood urea nitrogen,BUN)]、感染性休克率及病死率。结果治疗后,研究组患者Cr(71.32±5.79)μmol/L、BUN水平(9.81±0.59)mmol/L明显低于对照组[(92.13±6.74)μmol/L,(10.63±0.68)mmol/L],差异有统计学意义(t=15.581、6.057,P均<0.001)。治疗后,两组患者的PaCO_(2)水平均下降,PaO_(2)以及PaO_(2)/FiO_(2)水平均上升,且研究组各项指标优于对照组,差异有统计学意义(P均<0.05)。研究组在治疗14 d内的感染性休克发生率9.62%明显低于对照组26.92%,差异有统计学意义(χ^(2)=4.121,P<0.05)。两组患者病死率差异无统计学意义(P>0.05)。结论对严重脓毒血症患者在CVVH治疗基础上辅以参附注射液进行干预,可有效改善肺和肾的功能,有助于降低感染性休克率及病死率,改善临床预后。

Objective To explore the effect of Shenfu Injection-assisted continuous veno-venous hemofiltration in the treatment of patients with severe sepsis on their blood gas indexes and renal function.Methods A total of 104 patients with severe sepsis with acute renal failure who were treated in the Department of Critical Care Medicine in Affiliated Hospital of Xuzhou Medical University from June 2021 to June 2022 were conveniently selected as the study objects,and divided into the study group and the control group using random number table method,with 52 cases in each group.The control group was treated with continuous veno-venous hemofiltration(CVVH),and the study group was given Shenfu Injection for intervention on the basis of the control group.The blood gas indicators[partial pressure of blood oxygen(PaO_(2))and blood partial pressure of carbon dioxide(PaCO_(2)),oxygenation index(partial pressure of oxygen/fraction of inspired oxygen,PaO_(2)/FiO_(2))],renal function indicators[serum creatinine(Cr),blood urea nitrogen(BUN)],septic shock rate and mortality of the two groups before and after treatment were compared.Results After treatment,Cr(71.32±5.79)μmol/L and BUN levels(9.81±0.59)mmol/L in the study group were significantly lower than those in the control group[Cr:(92.13±6.74)μmol/L,BUN:(10.63±0.68)mmol/L],and the differences were statistically significant(t=15.581,6.057,both P<0.001).After treatment,the PaCO_(2)level of two groups of patients decreased,and the PaO_(2)and PaO_(2)/FiO_(2)levels increased,and the blood gas indicators in the study group were better than those in the control group,and the differences were statistically significant(all P<0.05).The septic shock rate in the study group within 14 days of treatment was significantly lower than that in the control group(9.62%vs 26.92%),and the difference was statistically significant(χ^(2)=4.121,P<0.05).There was no statistically significant difference in mortality rates between the two groups of patients(P>0.05).Conclusion In patients with severe sepsis,CVVH therapy combined with Shenfu injection intervention can effectively improve the functions of the lungs and kidneys,which helps reduce septic shock rate and mortality and improve clinical prognosis.