持续高容量血液滤过在严重脓毒症患者中的临床应用  

Clinical applications of high volume hemoffitration in patients with severe sepsis

作　　者：罗琼湘 廖晓星[2] 黄松彬 

机构地区：[1]河源市人民医院重症医学科,广东河源517000 [2]中山大学附属第一医院急诊科,广东广州510080

出　　处：《中国急救医学》2013年第11期966-968,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨持续高容量血液滤过（HVHF）对严重脓毒症患者的临床疗效.方法 选择2010-03 ～2013-03收治我科的严重脓毒症患者76例为研究对象,予HVHF治疗24h,监测治疗前及治疗后24 h的血流动力学变化及血浆白细胞介素-6（IL-6）、C-反应蛋白（CRP）和血乳酸（Lac）的变化.结果 患者治疗后较治疗前心排指数（CI）、平均动脉压（MAP）及中心静脉压（CVP）均升高（P＜0.05）,心率（HR）减慢（P＜0.05）；治疗后较治疗前血浆IL-6、CRP及Lac的平均水平降低（P＜0.05）.结论 持续HVHF可明显改善严重脓毒症患者的血流动力学变化,降低血乳酸和血浆中炎性介质的水平.Objective To study the effects of high volume hemofihration （HVHF） on patients with severe sepsis. Methods From March 2010 to March 2013, 76 patients with severe sepsis were selected and treated with HVHF for 24 hours. Changes of hemodynamic index, interleukin - 6 （ IL - 6）, C reactive protein （CRP） and lactic acid （Lac） in the plasma were measured or calculated at schelduled intervals. Results There were significant improvement in cardiac index （ CI）, mean arterial pressure （ MAP）, centralvenous pressure （ CVP）, and heart rat（HR） （P 〈 0.05 ）. Concentration of plasma IL - 6, CRP,and Lac obviously decreased after HVHF （ P 〈 0.05 ）. Conclusion HVHF has significant effects on hemodynamics, and can decrease concentration of lactic acid and plasma inflammatory cytokine in patients with severe sepsis.

关 键 词：高容量血液滤过(HVHF) 严重脓毒症 炎症因子 血流动力学 血乳酸(Lac) 

分 类 号：R459.5[医药卫生—治疗学]