连续性血液净化治疗全身性炎症反应综合征的研究  

Study on treatment of systemic inflammatory response syndrome with continuous blood purification

作　　者：王锦权[1] 刘宝[1] 厉小梅[1] 周彩平[1] 承韶晖[1] 范恒梅[1] 陶晓根[1] 高玉华[1] 

机构地区：[1]安徽省立医院ICU,安徽合肥230001

出　　处：《中国急救医学》2005年第1期6-8,共3页Chinese Journal of Critical Care Medicine

基　　金：安徽省卫生厅医学科研基金资助项目 (No 2 0 0 2B0 0 7)

摘　　要：目的　研究连续性血液净化 (CBP)治疗全身性炎症反应综合征 (SIRS)的疗效 ,并探讨其使用时机。方法　选择2 7例处于SIRS状态的患者给予CBP治疗 ,观察治疗前、中、后患者血液生化指标、血常规、血气分析和肿瘤坏死因子α(TNFα) ,并进行APACHEⅡ、SAPSⅡ和MODS评分。结果　与治疗前相比较 ,CBP治疗第 2天晨和CBP治疗结束后次日晨患者APACHEⅡ、SAPSⅡ和MODS评分较治疗前降低 ,治疗过程中氧合指数 (PO2 /FiO2 )有所改善 ,治疗过程中及治疗后压力调整心率 (PAHR)较治疗前降低。CBP治疗后 ,TNFα降低不明显。结论　CBP治疗SIRS疗效确切 ,但患者的预后与患者病情的严重程度和原发病能否有效得以控制有关 ;CBP治疗过程中患者心、肺功能有所改善 ;Objective To study the effect of treating systemic inflammatory response syndrome(SIRS) with continuous blood purification (CBP),and to discuss the applied occasion.Methods 27 SIRS patients were chosen and treated with CBP.Blood biochemical index,routine,gas analysis and tumor necrosis factor α (TNF α) were tested pre-,intra- and post-treatment of CBP.Meanwhile,APACHEⅡ,SAPSⅡ and MODS scores were graded.Results Compared with pre-treatment,APACHEⅡ,SAPSⅡ and MODS scores decreased on the second morning of intra-treatment and the next morning of post-treatment.Oxygenation index (PO 2/FiO 2) was improved during treatment.During and after treatment of CBP,pressure-adjusted heart rate (PAHR) decreased obviously.TNF α didn't decrease significantly after treatment.Conclusions It was sure the effect of treating SIRS with CBP.The prognosis of patients had a connection with severity of illness,and the disease could be controlled or not.Removing TNF α didn't play a role in treating SIRS with CBP.

关 键 词：连续性血液净化 全身性炎症反应综合征 危重症评分 肿瘤坏死因子Α 

分 类 号：R459.5[医药卫生—治疗学]