[精品][经典]间歇性高容量血液滤过治疗严重脓毒症的临床观察.doc

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1、［经典］间歇性高容量血液滤过治疗严重脓毒症的临床观察间歇性高容量血液滤过治疗严重脓毒症的临床观察［摘耍］B的:探讨间歇性高容量血液滤过(PHVHF)治疗严重脓毒症的疗效及应用。方法:将25例严重脓毒症患者随机分为PHVHF组13例、对照组12例。PHVHF组给予常规治疗，同时给予PHVHF治疗；对照组只给予常规治疗。观察治疗前、后急性生理学与慢性健康状况(APACHE)II评分;心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)等血流动力学指标;血液生化指标(BUN、Cr、K+、Na+、C1

2、-);氧合指数(Pa02/Fi02):机械通气时间、ICU内治疗时间,28d病死率。结果:PHVHF组治疗后HR、BUN、Cr>K+、PaO2/FiO2.APACHEII评分均较治疗前显著改善(P<0.05),其中，治疗后BUN、Cr、Pa02/Fi02、APACHEIT评分两组比较，差异有统计学意义(P<0.05);PHVHF组机械通气时间、TCU内治疗时间短,28d病死率低,其中，TCU内治疗时间，两组患者比较，差异有统计学意义(P〈0・05)o结论:PHVHF能稳定血流动力学，并通过对内环境

3、调节、改善氧合等，对多个器官起到支持作用,可减轻严重脓毒症的病情及改善预后，且操作简便，是严重脓毒症的有效治疗手段。［关键词］脓毒症;间歇性高容量血液滤过;血流动力学［中图分类号］R63［文献标识码］A［文章编号］1674-4721(2010)04(c)-033-03Clinicalobservationonintermittenthighvolumehemofi1trationtreatmentofseveresepsisHUANGTao(DepartmentofTCU,theRedCrossH

4、ospitaiofShenyang,Shenyang110013,China)［Abstract］Objective:Toinvestigatethetreatmenteffectivenessandapplicationofpulsehighvolumehemofiltration(PHVHF)inpatientswithseveresepsis・Methods:The25patientswithseveresepsiswererandomlydividedintoPHVHFgroup13cas

5、esandcontrolgroup12cases・PHVHFgroupwasgivenconventionaltreatment,whilegivingPHVHFtreatment;thecontrolgroupreceivedconventionaltherapyonly.Observedbeforeandaftertreatmentofacutephysiologyandchronichealthconditions(APACHE)IIscore;heartrate(HR),meanarter

6、ialpressure(MAP),centralvenouspressure(CVP)andotherhemodynamicparameters;bloodbiochemicalparameters(BUN,Cr,K+,Na+,C1-);oxygenationindex(Pa02/Fi02);mechanicalventilationtime,ICUtreatmenttimeperiod,28daysmortality・Results:Aftertreatment,PHVHFgroup'sHR,B

7、UN,Cr,K+,Pa02/Fi02,APACHEIIscorewassignificantlyimprovedthanthatbeforetreatment(P<0.05),which,aftertreatment,BUN,Cr,Pa02/Fi02,APACHEIIscorebetweenthetwogroups,thedifferencestatisticallysignificant(P〈0.05);PHVHFgroupofmechanicalventilation,ICUtreatment

8、withinashorttime,28daysmortalityratewaslow,whichICUtreatmenttimebetweenthetwogroupsofpatients,thedifferencewasstatisticallysignificant(P<0.05)・Conclusion:PHVHFcanstabilizehemodynamicsandhomeostasis,improveoxygenationtomultipleorganandplayasupp