连续性血液净化在脓毒症并MODS治疗中的应用  

Effect of continuous blood purification on sepsis and multiple organ dysfunction syndrome

作　　者：苗丽霞[1] 何本让[1] 姚华国[2] 

机构地区：[1]湖北医药学院附属东风总医院ICU,湖北十堰442000 [2]广东医学院附属第一医院ICU,广东湛江524001

出　　处：《海南医学院学报》2013年第4期521-523,527,共4页Journal of Hainan Medical University

基　　金：中国高校医学期刊临床专项资金项目(112210605)~~

摘　　要：目的:探讨连续性血液净化(continuous blood purification,CBP)治疗在脓毒症并多脏器功能不全综合征(MODS)患者中的疗效。方法:42例脓毒症并MODS[平均功能不全脏器(3.87±1.06)个]的患者予以CBP治疗,以连续性静脉-静脉血液滤过(CVVH)为主。连续性血液净化治疗期间监测生命体征,定时监测体温、血气、血常规、血管活性药物的应用以及内环境等。结果:42例患者在连续性血液净化治疗期间,血压逐步稳定,治疗后血尿素氮、肌酐及APACHEⅡ、MODS、SOFA评分及血管活性药物剂量均有所改善,乳酸、细胞间黏附分子(intercellular adhesion molecule 1,ICAM-1)的变化差异均有统计学意义(P<0.05)。结论:连续性血液净化是较好的治疗脓毒症并多脏器功能不全综合征的血液净化方法。Objective： To continuous blood purification （CBP） on sepsis and multiple organ dys- !unction syndrome （（MODS））. Methods： A total of 42 patients with MODS and sepsis Eaverage dysfunc- ：ional organs number （3.87± 1.06）] were given CBP therapy, with continuous veno-venous hemofiltration ：CVVH） as main therapy. During the CBP therapy, vital signs, as well as temperature, ABG, blood rou- ：ine examination, and internal environment etc were monitored on time. Results： During the CBP therapy,blood Pressures of the 42 patients were stable. After the therapy, several clinical indicators were im- proved, such as BUN, Cr, APACHE ]I scores, MODS scores, SOFA scores, and Vasoactive drugs dose. And there were significant differences in changes of lactic acid and intercellular adhesion molecule 1 （ICAM-1） levels between two groups （P^0.05）. Conclusions. CBP is a satisfactory therapy in the treat- ment of sepsis combined with MODS.

关 键 词：脓毒症 多脏器功能不全综合征 连续性血液净化治疗 

分 类 号：R457[医药卫生—治疗学]