中国血液净化

中国血液净化 ›› 2014, Vol. 13 ›› Issue (02): 93-95.doi: 10.3969/j.issn.1671-4091.2014.02.008

• 临床研究 • 上一篇    下一篇

脉冲式高容量血液滤过对胃肠肿瘤术后腹腔感染的疗效观察

彭俊琼,董文霞,储腊萍,俞娅芬   

  1. 江苏省无锡市第四人民医院肾内科
  • 收稿日期:2013-08-12 修回日期:2013-12-02 出版日期:2014-02-12 发布日期:2014-02-12
  • 通讯作者: 俞娅芬 1556864754@qq.com E-mail:1556864754@qq.com

Clinical observation on intermittent high volume hemofiltration treatment of Abdominal infection after Gastrointestinal cancer sugery

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  • Received:2013-08-12 Revised:2013-12-02 Online:2014-02-12 Published:2014-02-12

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摘要： 【摘要】目的 观察脉冲式高容量血液滤过（Pulse high volume hemofiltration，PHVHF）对胃肠肿瘤术后腹腔感染的疗效及应用。方法：将40例胃肠肿瘤术后并发腹腔感染患者随机分为PHVHF组20例，对照组20例。PHVHF组给予常规治疗及PHVHF治疗，对照组只给予常规治疗。观察治疗前后患者心率（HR），平均动脉压（MAP）及急性生理学与慢性健康状况（APACHE）II评分，ICU治疗时间，28d病死率。结果：PHVHF组治疗后心率（HR）、尿素氮（BUN）、肌酐（Cr）、血钾（K+）、 氧合指数（PaO2/FiO2）、APACHEⅡ评分均较治疗前显著改善(P<0.05)，其中，治疗后BUN、Cr、PaO2/FiO2、APACHEⅡ评分两组比较，差异有统计学意义（P<0.05）；PHVHF组ICU治疗时间短、28 d病死率低。两组患者比较28d病死率，差异有统计学意义(P<0.05)。结论：PHVHF能稳定血流动力学，并通过对内环境调节、改善氧合等，对多个器官起到支持作用，可减轻胃肠肿瘤术后腹腔感染的病情及改善预后，是有效的治疗手段。

关键词: 胃肠肿瘤术后, 腹腔感染, 脉冲式高容量血液滤过, 血流动力学

Abstract: Objective To investigate the effect of pulse high volume hemofiltration (PHVHF) in patients with abdominal infection after gastrointestinal cancer surgery. Methods Forty patients with abdominal infection after gastrointestinal cancer surgery were randomly divided into PHVHF group (n=20) and control group (n=20). Routine therapy was conducted to both groups of patients, with the addition of PHVHF to the patients in PHVHF group. APACHE Ⅱ score, heart rate (HR), mean arterial pressure, blood biochemical parameters (BUN, Cr and K+), oxygenation index (PaO2/FiO2), treatment period in ICU, and mortality within 28 days were assayed before and after the treatment. Results In PHVHF group after the treatment, HR, BUN, Cr, K+ , PaO2/FiO2, and APACHE Ⅱ score improved significantly (P＜0.05). The improvement of BUN, Cr, PaO2/FiO2 and APACHE Ⅱ score was more prominent in PHVHF group than in control group (P＜0.05). Mortality within 28 days was lower in PHVHF group (10.0%±0.8%) than in control group (22.0%±0.7%; t=4.305, P=0.036). Conclusion PHVHF stabilizes hemodynamics and homeostasis, improves oxygenation, and plays a supporting role to multiple organs, thus alleviates disease conditions, and improves prognosis in abdominal infection patients after gastrointestinal cancer surgery.

Key words: Abdominal infection after gastrointestinal cancer surgery, Pulse high volume hemoflitration, Hemodynamics