Analysis Of Therapeutic Effect Of Pulse High-volume Hemofiltration In Patients With Sepsis

Objectives:To investigate the therapeutic effect of pulse high-volume hemofiltration in patients with sepsis.Methods:From March 2016 to March 2018,the clinical data of 64 patients with sepsis who received emergency intensive care unit of the first affiliated Hospital of Kunming Medical University were analyzed retrospectively.According to the way of blood purification,the patients were divided into two groups:the control group(Continuous veno-venous hemofiltration,CVWH)(n = 34),and the experimental group(pulse high-volume hemofiltration,PHVHF)(n = 30).The general clinical data,sex,age,circulatory state(HR、MAP、CVP、Lac),pulmonary function(PH、OI),total body condition assessment(SOFA score、APACHEⅡ score)and inflammatory mediators(TNF-a、IL-10)were analyzed by SPSS 21.0 software,each p>0.05.The general data of the two groups had no statistical significance and were comparable.The data of circulatory state,pulmonary function improvement,systemic assessment,inflammatory mediator after treatment were statistically analyzed by SPSS 21.0 software.Ifp>0.05,the difference was not statistically significant,and if p<0.05,the difference was statistically significant.The advantages and disadvantages of two kinds of blood purification were analyzed.Results:After treatment,the breathing,circulation and systemic state of the experimental group and the control group were significantly improved,and the inflammatory mediators were also significantly decreased.There was a significant difference between the experimental group and the control group in the circulatory state(HR、MAP、CVP、Lac),pulmonary function(PH、OI),total body condition assessment(SOFA score、APACHEII score)and inflammatory mediators(TNF-a、IL-10)(p<0.05).At the same time,there was a strong correlation between the indexes of circulatory and pulmonary function and the inflammatory mediators(TNF-a、IL-10)。The ratio of(TNF-a、IL-10)in the experimental group was significantly higher than that in the control group after treatment.Conclusion(s):Pulse high volume hemofiltration(PHVHF)is more effective than continuous veno-venous hemofiltration in lowering the level of inflammatory mediators and improving the respiratory,circulatory and systemic state of sepsis patients.After treatment,the ratio of IL-10/TNF-a in the experimental group was significantly higher than that in the control group,suggesting that the pro-inflammatory effect was obviously weakened,the imbalance of anti-inflammatory response was partly corrected,and the out-of-control inflammatory response was alleviated.Circulation,pulmonary function and inflammatory mediators(TNF-a、IL-10)have a strong correlation.