摘要
Abstract
Objective To analyze the effect of continuous renal replacement therapy(CRRT)combined with high-vol-ume hemoperfusion on the short-term prognosis of patients with multi-drug resistant bacterial septic shock.Methods A total of 110 patients with multi-drug resistant bacterial septic shock admitted to our hospital from January 2021 to January 2024 were enrolled.According to the random number table method,they were divided into the control group(treated with CRRT alone,n=55)and the observation group(treated with CRRT combined with high-volume hemoperfusion,n=55).Hemodynamic indica-tors[heart rate,central venous pressure(CVP)serum lactic acid]inflammatory factors levels[interleukin-6(IL-6),procalcitonin(PCT),C-reactive protein(CRP)]before and after treatment were compared between the two groups.Blood gas indicators[partial pressure of carbon dioxide(PaCO2),blood oxygen saturation(SaO2),pH value,respiratory rate]and prognostic related indica-tors[length of ICU stay,duration of mechanical ventilation,incidence of combined multiple organ dysfunction(MODS),28-day mortality rate,and 90-day mortality rate]were also compared.Results After treatment,the heart rate,serum lactic acid level and CVP of both groups were lower than those before treatment,and the above indexes in the observation group were lower than those in the control group(P<0.05).The levels of inflammatory factors in both groups showed a downward trend after treatment,and the reduction amplitude in the observation group was more significant than that in the control group(P<0.05).After treat-ment,PaCO2,SaO2 and pH values were increased,while the respiratory rate was decreased.There were significant differences in blood gas indexes between the two groups(P<0.05).The length of stay in the ICU and the duration of mechanical ventilation in the observation group were shorter than those in the control group,and the incidences of combined MODS,28-day mortality rate,and 90-day mortality rate were lower than those in the control group(P<0.05).Conclusion CRRT combined with high-volume hemoperfusion in the treatment of mortality rate multi-drug resistant bacterial septic shock can effectively stabilize the vital signs of patients,alleviate their inflammatory responses,improve hemodynamics and blood gas indicators,reduce the risk of MODS and mortality,and further improve the short-term prognosis of patients.关键词
连续性肾脏替代治疗/高容量血液灌流/多重耐药菌/感染性休克/多器官功能衰竭/预后Key words
continuous renal replacement therapy/high-volume hemoperfusion/multi-drug resistant bacteria/infectious shock/multiple organ failure/prognosis
