连续性血液净化治疗严重脓毒症合并急性呼吸窘迫综合征临床研究  

The efficacy analysis of continuous blood purification in the treatment of severe sepsis complicated with acute respiratory distress syndrome

作　　者：刘振国[1] 王顺达[2] 王婷[3] 卢晓娥[1] Liu Zhenguo;Wang Shunda;Wang Tiug(Depart ment of Critical Care Medicine,Shaanxi Provincial People＇s Hospital（Xi＇an 710068)

机构地区：[1]陕西省人民医院重症医学科,西安710068 [2]陕西省人民医院康复医学科,西安710068 [3]陕西省人民医院西院一病区,西安710068

出　　处：《陕西医学杂志》2018年第7期880-882,共3页Shaanxi Medical Journal

摘　　要：目的:分析严重脓毒症合并急性呼吸窘迫综合征(ARDS)应用连续性血液净化(CBP)治疗的疗效。方法:选择收治的严重脓毒症合并ARDS患者50例,行回顾性分析。根据是否接受CBP治疗将全部患者分成对照组(30例)和实验组(20例)。对照组患者选择常规治疗,实验组患者在常规治疗基础上,给予CBP,观察分析临床疗效。结果:实验组治疗后48h、72h的氧合指数PaO2/FiO2水平较治疗前提高(P<0.05),并且显著高于对照组(P<0.05);实验组治疗后24h、48h、72h血清PCT水平显著低于对照组(P<0.05);实验组治疗后24h、48h、72hAPACHEII评分显著低于对照组(P<0.05);实验组患者的撤机成功率及28d存活率均显著高于对照组(P<0.05)。结论:应用CBP治疗严重脓毒症合并ARDS能早期改善氧合指数,明显提高撤机成功率和存活率。ObjectiveTo analyze the efficacy of continuous blood purification treatment for severesepsis complicated with acute respiratory distress syndrome.Method50 patients with severe sepsis complicated with acute respiratory distress syndrome in our hospital were selected for the retrospectively analysis from January 2015 to December 2016.All patients were divided into a control group（30 patients）and an experimental group（20 patients）according to whether received continuous blood purification.The patients in the control group were given conventional treatment,and the patients in the experimental group receivedwith continuous blood purification except conventional treatment.The clinical efficacy of the two groups was observed and analyzed.Result：Oxygenation index PaO2/FiO2 at48 hours and 72 hours after treatment in the experimental group was higher than that before treatment and much higher than that in the control group（P〈0.05）.The serum PCT level at 24 hours,48 hours and 72 hours after treatment in the experimental group was significantly lower than that in the control group（P〈0.05）,and APACHEII score at 24 hours,48 hours and 72 hours after treatment in the experimental group was significantly lower than that in the control group（P〈0.05）.The weaning success rate and the 28 day survival rate of the experimental group were significantly higher than the control group（P〈0.05）.Conclusion：The treatment of severe sepsis with ARDS by CBD can earlyimprove Oxygenation,andmarkedly improvethe weaning success rate and survival rate.

关 键 词：脓毒症 呼吸窘迫综合征 成人 血液滤过 

分 类 号：R631[医药卫生—外科学]