连续性静脉—静脉血液滤过对脓毒性休克预后的影响  

Effect of continuous venoveno-venous hemofiltration on the prognosis of septic shock

作　　者：季明霞[1] 斯小水[1] 何建新[1] 黄静[1] 郑文娟[1] 

机构地区：[1]义乌市中心医院重症医学科,浙江义乌322000

出　　处：《全科医学临床与教育》2013年第1期33-35,共3页Clinical Education of General Practice

摘　　要：目的探讨连续性静脉-静脉血液滤过(CVVH)对脓毒性休克患者预后的影响。方法将65例脓毒性休克患者随机分为血液净化治疗组和对照组。对照组给予常规治疗,治疗组在常规治疗的基础上予以连续2～13d的CVVH治疗。分别检测两组患者免疫细胞水平,并观察患者的C-反应蛋白(CRP)、ICU住院时间、机械通气时间。结果治疗后治疗组与对照组CD4+、CD8+及CD4+/CD8+比值均有上升,但治疗组与对照组治疗后比较,CD4+、CD8+及CD4+/CD8+比值均明显上升,差异均有统计学意义(t分别=2.07、2.05、2.23,P均<0.05);治疗组CRP、ICU住院时间、机械通气时间均较对照组明显下降,差异均有统计学意义(t分别=11.86、5.49、2.45,P均<0.05)。结论 CVVH能加强脓毒性休克患者的细胞免疫功能,减轻脓毒症患者的全身炎症反应,改善愈后。Objective To investigate the influence of continuous venoveno-venous hemofihration （CVVH） on the prognosis of septic shock. Methods Sixty five patients with septic shock were divided into the treatment group（n=33） and the control group （n=32）. The control group received conventional therapy. The treatment group received 2-13 days CVVH treatment on the basis of conventional treatment. The levels of immune cells were detected. C-reactive protein（CRP）, ICU length of stay and duration of mechanical ventilation were observed and compared. Results Compared with the control group ,serum CD4^＋, CD8^＋ and CD4^＋/CD8^＋ in peripheral blood after treatment were increased significantly （t=2.07,2.05,2.23, P〈0.05） while C reactive protein （CRP）, the length of ICU stay and ventilator time were decreased significantly （t= 11.86,5.49,2.45 ,P〈0.05）. Conchlsions CVVH can improve cellular immunity and reduce systemic inflammatory response so as to improve the prognosis of septic shock.

关 键 词：连续性静脉-静脉血液滤过 脓毒性休克 预后 

分 类 号：R459.7[医药卫生—急诊医学]