Observation on the effect of early application of blood filter for high volume blood filtration in emergency treatment and nursing of severe infectious shock
在重症感染性休克急诊救治护理中早期应用血滤机进行高容量血液滤过的效果观察

摘要

目的 探讨重症感染性休克急诊救治护理中早期应用血滤机进行高容量血液滤过的实际效果｡方法 选取2022年4月～2023年3月我院重症医学科收治的96例重症感染性休克患者为对象，采用随机数分法分为对照组（n=47例）与观察组（n=49例），给予对照组患者常规急诊护理模式，观察组在急诊护理早期应用血滤机进行高容量血液滤过，然后比较不同护理方案下的两组患者的炎性因子、心血管功能及APACHEⅡ、MODS评分等指标｡结果 观察组患者C反应蛋白、降钙素原等水平为51.65±5.85mg/L、7.52±2.09ng/L，均低于对照组的126.28±12.30mg/L、15.48±3.24ng/L；观察组患者动脉血压分压、氧合指数为376.71±56.58mmHg、141.43±29.75mmHg，均显著高于对照组的295.65±35.85mmHg、104.33±23.34mmHg，差异有统计学意义（p<0.05）；干预前，对照组、观察组患者的APACHEⅡ、MODS评分分别为27.01±2.79分、26.95±2.81分和14.83±1.26分、15.08±1.27分，组间差异不具有统计学意义（p>0.05）；干预后，对照组、观察组患者的APACHEⅡ、MODS评分分别为25.85±2.64分、20.95±2.34分和13.38±0.64分、11.93±0.93分，组间差异有统计学意义（p<0.05）｡结论 早期应用血滤机进行高容量血液滤过实施重症感染性休克患者急诊护理能显著改善患者炎性因子（降钙素原、C反应蛋白）水平、心血管功能（氧合指数、动脉血压分压）及多器官功能障碍，对促进患者机体康复具有积极临床应用价值｡

Abstract

Objective: To explore the practical effect of early application of hemofiltration machine for high volume hemofiltration in emergency treatment of severe septic shock.
Methods: 96 patients with severe septic shock from April 2022 to March 2023 were randomly divided into two groups: control group (n = 47) and observation group (n = 49). The observation group was given routine emergency nursing mode.
Results: The levels of C-reactive protein and procalcitonin were 51.65 ± 5.85 mg/L, 7.52 ± 2.09 mHg/L, which were lower than 126.28 ± 12.30 mg/L, 15.48 ± 3.24 ng/L in the control group; the arterial blood pressure fractional pressure and oxygenation index were 376.71 ± 56.58 mHg, 141.43 ± 29.75 mHg, which were significantly higher than 295.65 ± 35.85 mHg, 104.33 ± 23.34 mHg (p < 0.05) in the control group; before intervention, the APACHE II, MODS scores were 27.01 ± 2.79, 26.95 ± 2.81 and 14.83 ± 1.26, 15.08 ± 1.27 in the control group, which were not statistically significant (p > 0.05) in the control group; after intervention, the APACHE II, APACHE II and APDS scores of the control group were 25.85 ± 2.64, 2094.93 ± 2.93 and 0.34 ± 2.34, and 0.64 ± 0.05 respectively.
Conclusion  : Early application of high volume hemofiltration in emergency nursing for severe septic shock patients can significantly improve the level of inflammatory factors (calcitonin, C-reactive protein), cardiovascular function (oxygenation index, arterial blood pressure partial pressure) and multiple organ dysfunction.