中国血液净化

›› 2004, Vol. 3 ›› Issue (9): 484-486.

• 论著 • 上一篇    下一篇

持续静脉-静脉血液滤过治疗严重乳酸酸中毒的临床观察

熊旭明 刘卫江 罗辉遇 谢长江 温德良 古英明   

  1. 510260 广州， 广州医学院第二附属医院危重病学科 (熊旭明，刘卫江，罗辉遇，谢长江，温德良)；血液透析中心(古英明)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-09-12 发布日期:2004-09-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-09-12 Published:2004-09-12

RichHTML

0

PDF

168

摘要：

目的 探讨应用持续静脉-静脉血液滤过 （CVVH）治疗严重乳酸酸中毒的价值。方法 对我 院危重病监护病房2000年6月～2004年3月收治的25例严重乳酸酸中毒进行回顾性分析。25例患者分为两组，常规组（13例）接受常规治疗，CVVH组（12例）在常规治疗的基础上应用CVVH，观察分析两组患者治疗前后血乳酸、血pH的变化，CVVH清除乳酸的效果，患者的死亡率。结果 两组患者血乳酸下降、血pH上升的速度有显著性差异(P<0.05)， CVVH组优于常规组；CVVH滤过液中乳酸的含量与同时段血乳酸基本相同；两组患者的死亡率无显著差异( P>0.05)，但 CVVH组患者的APACHE II评分明显高于常规组 (P<0.05)。结论 应用 CVVH治疗能改善严重乳酸酸中毒患者的内环境，维持酸碱平衡，CVVH具有清除血乳酸的作用，并能改善患者的预后。

关键词: 持续静脉-静脉血液滤过, 乳酸酸中毒, 治疗

Abstract:

Objctive To discuss therapeutic value of continuous veno-venous hemofiltration (CVVHF) on serious lactic acidosis. Methods A total of 25 cases with serious lactic acidosis in intensive care unit during June of 2000 to March of 2004 were studied. Patients were divided into two groups, regular group(n=13) patients accepted routine treatment, CVVHF group patients(n=12) accepted routine treatment and CVVHF. The level of lactic acid and PH in plasma before and after treatment、efficiency of clearing of lactic acid from plasma by CVVHF and mortality rate were observed. Results The fall speed of lactic acid level in plasma and raise speed of PH of arterial blood in two groups was significantly different (P<0.05), CVVHF group was faster. The lactic acid level in effluent was close to that in plasma. The mortality rate in two groups had no difference (P>0.05), but the score of APACHE II in CVVHF group was significantly higher than that in routine group (P<0.05). Conclusion CVVH might improve inner environment and keep acid-alkali balance of patients with serious lactic acidosis, it can remove lactic acid from blood and might improve prognosis of patients with serious lactic acidosis.

Key words: Lactic acidosis, Treatment 

中图分类号: