›› 2010, Vol. 9 ›› Issue (1): 29-31.

• 临床研究 • 上一篇    下一篇

脉冲式高容量血液滤过在严重脓毒症患者中的应用

卜会驹 林小茂 温海洋 陈 亮   

  1. 中山大学附属东华医院ICU
  • 收稿日期:2009-12-09 修回日期:1900-01-01 出版日期:2010-01-12 发布日期:2010-01-12

Application of pulse high volume hemofiltration in severe sepsis patients

BU Hui-ju, LIN Xiao-mao, WEN Hai-yang. CHEN Liang   

  1. ICU, Donghua Hospital, Dongguan 523110, China
  • Received:2009-12-09 Revised:1900-01-01 Online:2010-01-12 Published:2010-01-12

摘要:

【摘要】 目的 探讨脉冲式高容量血液滤过在严重脓毒症病人中的应用价值。 方法 严重脓毒症病人49例,按照随机原则分为:A组25例(脉冲式高容量血液滤过组),B组24例(持续高容量血液滤过组),进行不同方法的血液滤过治疗,记录开始和72小时后APACHE Ⅲ评分,平均动脉压(MAP),血管活性药用量,凝血功能,生化指标,炎症指标的变化。还记录每组病人的滤器平均使用时间,置换液使用总量,肝素使用总量,28天病死率等数据,进行比较分析。 结果 治疗72小时后,A,B两组之间平均动脉压,去甲肾上腺素用量,炎症指标水平均没有明显统计学差异(P>0.05)。B组使用的置换液量比A组明显增多,滤器平均使用时间明显缩短,B组血小板下降,APTT延长,血红蛋白下降的程度对比A组更为明显(P<0.05)。 结论 在严重脓毒症病人中,脉冲式高容量血液滤过,可以达到持续高容量血液滤过的效果,又可以节约液体,耗材,减少对血液,凝血系统的影响。

关键词: 脉冲式高容量血液滤过, 高容量血液滤过, 血液滤过, 严重脓毒症

Abstract:

【Abstract】Objective To research the advantages of pulse high volume hemofiltration in severe sepsis patients. Methods A total of 49 severe sepsis patients were divided randomly into 2 groups: group A, treated with pulse high volume hemofiltration (PHVHF group, n=25); group B, treated with high volume hemofiltration (HVHF group, n=24). APACHE III score, mean artery pressure (MAP), vasoactive drug used, blood coagulation function, biochemistry paameters, inflammation markers were recorded before and after the treatment for 72 hours. The average dialysis time, amount of exchanged dialysate, heparin used, and mortality rate in a 28 day period were compared between the 2 groups. Results After treatment for 72 hours, MAP, norepinephrin used and inflammation markers were similar between the 2 groups (P>0.05). Compared with patients in group B, patients in group B used more amount of exchanged dialysate, and had shorter dialysis time. decrease of thrombocyte, extend of APTT, decrease of hemoglobin in group B were more obviously than group A (P<0.05). Conclusions Pulse high volume hemofiltration in severe sepsis patients could had effects similar to continuous high volume hemofiltration. It could save liquids and materials, reduce influences to blood and thromboxane system at the same time.

Key words: High volume hemofiltration, Haemofiltration, Severe sepsis