连续血液净化在儿童严重脓毒症中的应用  

Application of continuous blood purification in children with severe sepsis

作　　者：张晨美[1] 朱益飞[2] 

机构地区：[1]浙江大学医学院附属儿童医院PICU,杭州310003 [2]浙江省江山市人民医院儿科

出　　处：《中华实用儿科临床杂志》2015年第6期412-415,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：脓毒症的发病机制复杂，目前严重脓毒症的治疗仍是一大难题。感染性因素侵袭机体后，引起其过度释放细胞因子和炎性介质，导致炎性反应失控和免疫功能紊乱，进而发展成为脓毒症及严重脓毒症。连续血液净化技术具有强大的溶质清除功能，能清除体内过多水分、代谢废物、毒物及各种细胞因子、炎性介质。¨前，该技术不单纯应用于肾脏疾病，而是被广泛应用于各种急危重症的抢救治疗。近年来，不同脓毒症相关的治疗指南中均提出连续血液净化是治疗严重脓毒症的重要手段之一。早期应用连续血液净化治疗儿童严重瞅毒症，可明显改善患儿的心肺功能、肾功能、免疫功能及凝血功能等。该技术在儿童严重脓毒症中的应用将会越来越重要，但仍存在一些问题有待进一步研究，确定对脓毒症患儿进行个体化治疗将是今后研究的重点。The mechanism of sepsis is complicated,currently the treatment of severe sepsis is still a challenge. When infected, the body would release cytokines and inflammatory mediators, resulting in out of control of inflammatory reaction and disorder of immune system. Furthermore, sepsis and severe sepsis will be developed. The technique of continuous blood purification （CBP）can powerfully clear solute as water, metabolic wastes, toxic substances,cytokines and inflammatory mediators. Now this technique is not only applied in renal disorders, but also widely used in rescue treatment fbr critically ill patients. Recently,the guide of sepsis recommended CBP as a method of treating severe sepsis. With CBP application in the early stage of children severe sepsis,it can improve function of heart and lung function,renal function,immune function,coagulation function, and etc. CBP is becoming more and more important in the treatment of children severe sepsis. There are some remaining problem to be resolved, and the individaulized treatment for children sepsis is the focus in the future study.

关 键 词：严重脓毒症 连续血液净化 儿童 

分 类 号：R720.597[医药卫生—急诊医学]