CHVHF治疗严重脓毒症合并多器官功能障碍综合征的疗效及对血流动力学的影响  

Clinical effect of CHVHF on severe sepsis complicated with multiple organ dysfunction syndrome and its effect on hemodynamics

作　　者：张良 张涛 卞康 武杜鹃 ZHANG Liang;ZHANG Tao;BIAN Kang;WU Du-juan(Xianyang Central Hospital,Xianyang 712000,China)

机构地区：[1]咸阳市中心医院,陕西咸阳712000

出　　处：《临床医学研究与实践》2018年第9期23-24,共2页Clinical Research and Practice

摘　　要：目的探讨持续高容量血液滤过(CHVHF)治疗严重脓毒症合并多器官功能障碍综合征(MODS)的疗效及对血流动力学的影响。方法选取我院收治的严重脓毒症合并MODS患者60例为研究对象,随机分为对照组和观察组,各30例。对照组给予常规容量血液滤过(CVHF)治疗,观察组给予CHVHF治疗。比较两组患者的临床治疗效果。结果治疗后,两组患者的体温、MODS评分及急性生理与慢性健康(APACHEⅡ)评分均明显低于治疗前,且观察组明显低于对照组(P<0.05);治疗后,两组患者的心率(HR)及外周血管阻力指数(SVRI)水平均降低,有创动脉压(MAP)水平均升高,且观察组HR及MAP水平明显高于对照组,SVRI水平明显低于对照组(P<0.05)。结论严重脓毒症合并MODS患者给予CHVHF治疗,可稳定生命体征,改善血流动力学,值得临床推广应用。Objective To investigate the clinical effect of continuous high volume hemofiltration(CHVHF)on severe sepsis complicated with multiple organ dysfunction syndrome(MODS)and its effect on hemodynamics.Methods Sixty patients with severe sepsis complicated with MODS admitted in our hospital were selected and randomly divided into control group and observation group,with 30 cases in each group.The control group received conventional volume hemofiltration(CVHF),and the observation group was treated with CHVHF.The clinical effects of the two groups were compared.Results After treatment,the body temperature,MODS scores and acute physical and chronic health(APACHE域)scores of the two groups were lower than those before treatment,and those of the observation group were lower than the control group(P<0.05).After treatment,the levels of heart rate(HR)and peripheral vascular resistance index(SVRI)of the two groups decreased,and the invasive arterial pressure(MAP)level increased in addition,the levels of HR and MAP of the observation group were higher than those of the control group,and the SVRI level was lower than that of the control group(P<0.05).Conclusion CHVHF applied in severe sepsis patients with MODS can stabilize vital signs,and improve hemodynamics,which is worthy of clinical popularization and application.

关 键 词：持续高容量血液滤过(CHVHF) 常规容量血液滤过(CVHF) 脓毒症 多器官功能障碍综合征(MODS) 血流动力学 

分 类 号：R459.7[医药卫生—急诊医学]