连续性血液滤过技术在劳力性热射病紧急救治中的应用  

Application of Continuous Venus-Venus Hemodiafiltration in the treatment of Exertion Heat Stroke

作　　者：张晓东[1] 宋洁[1] 李瑛[1] 张燕燕[1] 李辉[1] 

机构地区：[1]中国人民武装警察部队后勤学院附属医院肾脏病科,天津300162

出　　处：《中国急救复苏与灾害医学杂志》2012年第4期331-333,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的探讨连续性血液滤过（CVVH）技术在劳力性热射病（ExHS）紧急救治中的作用。方法回顾性总结2006年8月～2011年7月本院收治的20例ExHS患者临床资料，根据救治过程中有无采用CVVH技术治疗分为CVVH组（n=11）及常规治疗组（n=9），比较两组患者住院时间，多脏器功能不全（MODs）发病率、病死率，治疗前及治疗1周后APACHEⅡ评分、血浆肌酸激酶（CK）、乳酸脱氢酶（LDH）、肌酐（Scr）、尿素氮（BUN）、C反应蛋白（CRP）、前降钙素（PCT）水平。结果CVVH组较常规治疗组患者住院时间明显缩短，MODS发病率、病死率下降，差异有统计学意义（均P〈0．05）；2组患者治疗前APACHEⅡ评分，血清CK、LDH、BUN、Scr、PCT、CRP水平差异无统计学意义（均P〉0．05），治疗1周后CVVH组APACHEⅡ评分，血清CK、LDH、BUN、Scr、PCT、CRP水平较常规治疗组降低，差异有统计学意义（均P〈0．05）。结论及时采用CVVH技术对ExHS患者进行救治能有效抑制ExHS患者炎症反应，改善EHS患者病情及预后，是治疗ExHS至关重要的临床方法。Objective To investigate the therapeutic effect of continuous venus-venus hemodiafiltration （CVVH） in treatment of exertion heat stroke （ExHS）.Method Clinical data of 20 patients with ExHS from our hospital from Aug 2006 to Jul 2011 were retrospectively analyzed.Patients were assigned into CVVH group （n= 11） and conventional therapy group （n=9）according to receiving or not receiving the treatment of CVVH.The length of patients hospital stay, the rate of morbidity of multiple organ dysfunction （MODS） and mortality were Compared.The value of CK,LDH,Scr,BUN,CRP,PCT and APACHE II were Compared between the 2 groups before the treatment of CVVH and one week later. Result The length of patients hospital stay, the rate of morbidity of multiple organ dysfunction （MODS）and mortality in CVVH group were lower than in conventional therapy group （P 〈0.05）, The value of CK,LDH,Scr, BUN,CRP,PCT and APACHE II in CVVH group after one-week treatment of CVVH were lower than in conventional therapy group （P 〈0.05）. Conclusion The treatment of CVVH timely results in alleviation of inflammation effectively ,improvement of vital signs and prognosis,thus it is valuble therapeutic method in the treatment of ExHS.

关 键 词：连续性血液滤过技术 劳力性热射病 救治 

分 类 号：R459.7[医药卫生—急诊医学]