Observation on the application effect of high volume hemofiltration in the treatment of severe septic shock
高容量血液滤过在重症感染性休克治疗中的应用效果观察

摘要

目的 研究重症感染性休克患者治疗方法，探讨高容量血液滤过的临床效果和应用价值。方法选取2020年2月-2021年12月期间诊治的84例重症感染性休克病人作为研究重点，分为A组和B组，各42例。B组实施补液、抗感染等常规治疗，A组除了给予B组同样的治疗之外，还进行高容量血液滤过。评估两种治疗措施对病情的改善情况。结果 治疗后疾病程度情况如MODS及APACHE-II评分均显著下降，A组（10.23±1.66、21.46±2.82）降幅显著大于B组（13.07±1.43、26.33±2.05）（P＜0.05），患者器官功能改善及病情恢复情况更乐观；血清TNF-α、IL-6水平对比，A组平均值降幅显著大于B组（P＜0.05），炎症反应缓解较快，抗感染疗效更佳；血清总胆红素、血氧分压对比，两组均增高，A组增幅远大于B组（P＜0.05），患者代谢及循环功能纠正更显著；肌酐、谷丙转氨酶值两组均有所下降，且A组降幅明显大于B组（P＜0.05）。结论 高容量血液滤过较常规补液、抗感染疗法效果更好，能显著降低疾病及器官功能障碍的严重程度，缓解炎性病变，其应用价值更高，临床可借鉴推广。

Abstract

Objective To study the treatment methods of patients with severe septic shock, and to explore the clinical effect and application value of high-volume hemofiltration.
Methods A total of 84 patients with severe septic shock who were diagnosed and treated from February 2020 to December 2021 were selected as the research focus, and they were divided into group A and group B, with 42 cases in each. Group B was given routine treatment such as fluid replacement and anti-infection, while group A was given the same treatment as group B, and also underwent high-volume hemofiltration. The improvement of the condition of the two treatments was evaluated.
Results The degree of disease after treatment, such as MODS and APACHE-II scores, were significantly decreased, and the decrease in group A (10.23±1.66, 21.46±2.82) was significantly greater than that in group B (13.07±1.43, 26.33±2.05) (P<0.05). Function improvement and disease recovery were more optimistic; compared with serum TNF-α and IL-6 levels, the average decrease in group A was significantly greater than that in group B (P<0.05), the inflammatory response was relieved faster, and the anti-infection effect was better; Compared with red blood and blood oxygen partial pressure, the two groups were increased, the increase in group A was much greater than that in group B (P<0.05), and the patient's metabolism and circulatory function were corrected more significantly; creatinine and alanine aminotransferase values decreased in both groups, and The decrease in group A was significantly greater than that in group B (P<0.05).
Conclusion   High-volume hemofiltration is more effective than conventional rehydration and anti-infective therapy. It can significantly reduce the severity of diseases and organ dysfunction, and relieve inflammatory lesions. Its application value is higher, and it can be used for reference in clinical practice.