动静脉血液滤过治疗对外科感染性休克患者血流动力学影响的研究

Effect of arterio-venous blood filtration to hemodynamics on infection shock in operation

目的观察外科感染性休克患者在手术中行体外抗凝动静脉血液滤过治疗对其血流动力学的影响。方法将71例临床诊断为感染性休克行手术清除病灶患者随机分为对照组(Ⅰ组)和血液滤过组(Ⅱ组)。Ⅰ组患者在手术的同时进行抗休克治疗,Ⅱ组患者在抗休克治疗的基础上进行体外抗凝血液滤过治疗。观察2组患者术中心率(HR)、收缩压(SBP)、中心静脉压(CVP)和尿量;并比较2组患者术中血管活性药物的用药情况。结果2组患者手术期间的HR、SBP、CVP和尿量差异无统计学意义(P均>0.05);Ⅱ组患者血管活性药物的用药量低于Ⅰ组(P<0.05)。.结论:感染性休克患者手术中行体外抗凝动静脉血液滤过治疗可有效滤出患者体内的内毒素及炎性递质,使血流动力学更稳定,提高治愈率,降低病死率。

Objective It is to observe the influence of blood filtration on the hemodynamics of the infection patients in operation. Methods 71 patients of infection shock were randomly divided into two groups, that were normal control group（ group Ⅰ ） and blood filtration group（group Ⅱ ）. Group Ⅰ were only cured shock, group Ⅱ were cured shock and filtrated blood in the same time. In operation,heart rate, contractive pressure, central venous pressure and urine quantity were observed respectively, and comparing the two groups in the doses of vasoactive agent. Results Heart rate, contractive pressure, central venous pressure and urine quantity had no significant difference between two groups（ P 〉 0.05）. The doses of vasoactive agent in group Ⅱ is apparently lower than that of group Ⅰ （P 〈 0.05）. Conclusion ：The blood filtration for the patients of infection shock in the operation can effectively filter out the toxin and the inflammatory medium, make hemodynamics more stabilitily, and improving the cure rate and decreasing the death rate.