高容量血液滤过对严重创伤后血浆炎性介质及血流动力学的影响

Effects of high volume hemofiltration (HVHF) on plasma inflammatory cytokine and hemodynamics in the patients after severe trauma

目的研究高容量血液滤过(HVHF)对严重创伤后血浆炎性介质及血流动力学的影响。方法选择2004-06～2007-03我科收治的严重多发伤患者32例为研究对象,行HVHF治疗,放置Swan-Ganz漂浮导管,测定滤过前后血浆炎性介质水平和血流动力学的变化。结果与滤过前比较,滤过后TNF-α、IL-1β、IL-6、C反应蛋白(CRP)水平均明显降低,MAP、SVRI、CVP、CI均无明显变化。结论HVHF可显著降低严重创伤患者血液中炎性介质的水平,对血流动力学状态无明显影响。

Objective To study the effects of high volume hemofiltration（HVHF） on plasma inflammatory cytokine and hemodynamics in the patients after severe trauma. Methods From June 2004 to March 2007, 32 patients with severely multiple trauma were selected and treated with HVHF. Plasma in- flammatory cytokine and hemodynamics were measured or calculated at sehelduled intervals by use of Swan Ganz Catheters. Results Concentration of plasma inflammatory cytokine obviously decreased after HVHF, while mean arterial pressure （MAP） , indices of systemic vascular resistance （SVRI） , central venous pressure（ CVP）, cardiac index（C]） has no significant changes after the HVHF. Conclusion HVHF can decrease concentration of plasma inflammatory eytokine in the patients with severe trauma and has no significant effects on hemodvnamics.