中国血液净化

›› 2006, Vol. 5 ›› Issue (8): 416-417.

• 论著 • 上一篇    下一篇

高通量血液滤过在严重脓毒血症中的临床分析

郑永科 刘长文 朱克毅 陆 俊 胡 炜 周 挺   

  1. 310006 杭州，浙江省杭州市第一人民医院危重病医学科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2006-08-12 发布日期:2006-08-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2006-08-12 Published:2006-08-12

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摘要： 目的 探讨高通性血液滤过(HVHF)在严重脓毒血症治疗中的临床作用。方法 选择浙江省杭州市第一人民医院危重病医学科32例严重脓毒血症患者进行HVHF[流量80ml/(Kg·h)]治疗，观察治疗前后患者炎性介质(TNF-a、IL-6、IL-8、IL-10)、氧合指数、APACHE-Ⅱ评分、MODS评分、TFC的变化。结果 32例患者经HVHF首次治疗后氧合指数改善，APACHE-Ⅱ、MODS评分和TNF-a、IL-6、IL-8 也有明显下降，差异均有显著性(P＜0.05)，而IL-10无明显下降。经多次治疗后，最终患者TFC、APACHE-Ⅱ、MODS评分明显下降，有统计学意义（P＜0.05)。结论 HVHF可以改善严重脓毒血症患者的呼吸功能，改善患者的生命体征，并能缓解病情。

关键词: 高通量血液滤过, 脓毒血症

Abstract: Objective To evaluate the clinical efficacy of high-volume hemofiltration(HVHF) on treating severe sepsis. Methods Data of 32 patients with severe sepsis treated by HVHF were collected and the differences of oxygenation indices, APACHE-Ⅱscores, MODS scores and TFC before and after HVHF therapy were observed. Results After the first treatment HVHF, patients’ oxygenation indices improved apparently. APACHE-Ⅱscores,MODS scores and TNF-α,IL-6,IL-8 also decreased significantly(P ＜0.05). Yet IL-10 level did not decrease. After several times of HVHF treatments,finally patiants oxygenation indices apparently improved,APACHE-Ⅱscores,MODS scores and TFC decreased significantly (P ＜0.05).Conclusion　HVHF can improve respiratory function of patients with severe sepsis, improve vital signs of patients and relieve the severity of the illness.

Key words: Sepsis

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