高通量血液滤过在严重脓毒血症中的临床分析  

The clinical efficacy of high-volume hemofiltration on severe sepsis

作　　者：郑永科[1] 刘长文[1] 朱克毅[1] 陆俊[1] 胡炜[1] 周挺[1] 

机构地区：[1]浙江省杭州市第一人民医院危重病医学科,杭州310006

出　　处：《中国血液净化》2006年第8期416-417,共2页Chinese Journal of Blood Purification

基　　金：杭州市卫生局级科研课题(编号:2003A002)

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。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-Ⅱ scores, MODS scores and TFC before and after HVHF therapy were observed. Results After the first treatment HVHF, patients＇ oxygenation indices improved apparently. APACHE-Ⅱ scores, MODS scores and TNF-αa ,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-Ⅱ scores, NODS 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.

关 键 词：高通量血液滤过 脓毒血症 

分 类 号：R459.5[医药卫生—治疗学]