Clinical Research Of High Volume Hemofiltration In The Therapy Of Sepsis

Sepsis and sepsis-induced multiple organ dysfunction syndrome(MODS) was the main cause of fatality of patients in comprehensive intensive care unit.Internal and abroad researches revealed the mortality of sepsis retained high,depressing the mortality of sepsis had important clinical significance. High volume hemofiltration(HVHF)was applicated generally in the therapy of sepsis and MODS recently.Massive researches indicated HVHF could cleared mediators of inflammation efficiently, lessen damage of organs, improved pathogenetic conditions, accordingly elevated survival of sepsis.TO discuss the therapeutic effects of HVHF in the therapy of sepsis and the influential factors of prognosis of sepsis patients,rudiment explored initiate opportunity of HVHF in the therapy of sepsis plus acute kidney injury(AKI).Retrospective analyze clinical data of 152 patients with sepsis who received HVHF therapy.undertake APACHEⅡ,APACHEⅢ,SAPSⅡevaluation before therapy and after therapy 24 hours,48hours,72hours.by 28 day survivorship,we divided patients into survival group and dead group,compared variance of clinical indicator before and after therapy 24 hours,48 hours,72 hours in subgroup respective,analyzed risk factors which influence prognosis of patients by multiple regression analysis,and analyzed the influence of AKI stages on prognosis of sepsis patients.Lung and alimentary tract were the frequent infection sites of sepsis patients;28 day after HVHF therapy,74 patients (48.68%) survivaled,78 patients (51.32%) died among 152 patients,4 patients(2.63%) need sequent renal replacement therapy among survivals,28 day mortality was lower obviously than the mortality 88.78±17.72% predicted by APACHEⅢ;APACHEⅡ,APACHEⅢ,SAPSⅡscores descent remarkably(p<0.01) after therapy 24 hours;Age,quantities of failured organ,APACHEⅡ,APACHEⅢ,SAPSⅡscores,founddiseases,shock,acute kidney injury (AKI),severe acute pancreatitis,alimentary tract hemorrhage,cataphora and the use of pressor agent correlated intimately with 28 day survival rate,found diseases,APACHEⅢwere independent risk factors;renal function recovery rate in AKI 1 stage was higher than AKI 2,3 stage(p<0.05),28 day mortality of none AKI patients was lower than AKI 1,2,3 stages (p<0.05), but 28 day mortality hasn't obviously variance between AKI 1,2,3 stages(p>0.05).Prognosis of patients with sepsis was poor,HVHF could improve biochemical indicator of patients efficiently,improve prognosis,elevate survival rate.Found diseases,APACHEⅢwere independent risk factors which influent 28 day mortality of sepsis patients.28 day mortality of none AKI patients was lower obviously than AKI 1,2,3 stages, AKI stages had certainly correlation with 28 day renal function recovery rate, hadn't obviously correlation with 28 day mortality.