应用血浆置换治疗早期感染性休克效果分析  

Plasma exchange in treatment of early septic shock:its clinical efficacy

作　　者：张爱红[1] 郑全辉[2] 

机构地区：[1]唐山市工人医院ICU,河北唐山063000 [2]河北联合大学免疫教研室,河北唐山063000

出　　处：《中华医院感染学杂志》2012年第13期2812-2813,共2页Chinese Journal of Nosocomiology

摘　　要：目的探讨血浆置换治疗早期感染性休克的效果。方法选取2009年1月-2011年8月医院进行治疗的23例早期感染性休克患者为观察组,同期的23例感染性休克患者为对照组,观察组在对照组的基础上加用血浆置换方案进行治疗后,将两组患者治疗前及治疗后12h的血清肌酐(Cr)、平均动脉压(MAP)、中心静脉压(CVP)及动脉血氧饱和度(SaO2)水平及总多巴胺使用量、多器官功能障碍综合征(MODS)、急性肾功能衰竭(ARF)发生率、死亡率进行比较。结果观察组治疗后12h的血清Cr(105.6±10.9)μmol/L低于对照组,MAP(72.3±3.5)mmHg、CVP(10.6±1.5)mmHg及SaO2(96.2±3.2)%水平高于对照组,总多巴胺使用量(178.5±25.4)mg小于对照组,MODS(21.74%)、ARF(8.70%)发生率、死亡率(8.70%)低于对照组,差异均有统计学意义(P<0.05)。结论血浆置换治疗早期感染性休克的效果好,显效快,预后较好。OBJECTIVE To investigate the effect of plasma exchange in the treatment of early septic shock.METHODS A total of 23 patients with early septic shock who were treated in hospital from Jan 2009 to Aug 2011 were selected as the observation group,and another 23 cases of septic shock patients at the same period were set as the control group.The observation group was treated with the additional plasma exchange program on the basis of the treatment in the control group.The serum Cr,MAP,the level of CVP and SaO2 before and 12 hours after treatment and the total consumption of dopamine,the incidence of MODS and ARF,and the mortality rates of the two groups were compared.RESULTS The serum Cr（105.6 ± 10.9） μmol/L of the observation group 12 hours after treatment was lower than that of the control group,the levels of MAP（72.3±3.5） mmHg,CVP（10.6±1.5） mmHg and SaO2（96.2±3.2）% of the observation group were higher than those of the control group,the total consumption of dopamine（178.5±25.4）mg of the observation group was less than that of the control group,the incidence of MODS（21.74%）,ARF（8.70%） and the mortality（8.70%） of the observation group were lower than those of the control group,the differences were statistically significant（all P〈0.05）.CONCLUSION Plasma exchange in the treatment of early septic shock can achieve a good clinical effect and show the effectiveness rapidly as well as make a good prognosis.

关 键 词：血浆置换 早期感染性休克 效果 

分 类 号：R181.32[医药卫生—流行病学]