连续性血液净化在治疗重症脓毒血症中的应用

The Effect of Continuous Blood Purification in Treatment of Patients with Severe Sepsis Patients

目的:探讨连续性血液净化(CBP)治疗重症脓毒血症患者的疗效。方法:对30例重症脓毒血症患者,在CBP治疗前、治疗期间及治疗结束后分别监测患者血流动力学参数、呼吸机参数及急性生理和慢性健康状况评分(APACHEⅡ),测定动脉血气、肾功能、电解质,记录多巴胺用量及呼吸机参数。结果:所有治疗均进行顺利,经过CBP治疗,患者血流动力学较治疗前改善;氧合指数(PaO2/FiO2)、动脉氧分压(PaO2)均升高、吸入氧浓度(FiO2)下调,与治疗前比较差异有统计学意义(P<0.05);平均动脉压(MBP)升高,多巴胺的需要量明显减少(P<0.05);APACHEⅡ评分、肌酐、尿素氮、血钾水平较治疗前明显降低(P<0.05)。结论:CBP能改善重症脓毒血症患者的血流动力学状况及肺氧合功能,维持内环境稳定,是一种可行、有益的辅助治疗重症脓毒血症的方法。

Objective ：To discuss the effect of continuous blood purification （ CBP ） in treatment of patients with severe sepsis patients.Methods： 30 patients with severe sepsis patients, in the CBP before treatment, during treatment and after treatment respectively monitor the hemodynamics of patients with ventilator parameters, and acute physiology and chronic health evaluation （ APACHE Ⅱ ）, arterial blood gas measurements, renal function, electrolyte, recording of dopamine content and ventilator parameters.Results：All treatments were performed smoothly, after CBP treatment than before treatment, patients with hemodynamic improvement ; oxygenation index （PaO2/FiO2 ）, arterial partial pressure of oxygen （PaO2）were increased, inspired oxygen concentration （ FiO2 ） down, and before treatment has significant difference （P〈0.05） ; mean arterial pressure （ MBP elevated dopamine ）, the need quantity decreased obviously （P〈0.05） ; APACHE II score, creatinine, blood urea nitrogen, serum potassium levels significantly decreased compared with those before treatment （ P〈0.05 ）.Conclusion：CBP can improve in patients with severe sepsis hemodynamics and oxygenation function, to maintain a stable environment within, is a practical, useful adjunctive therapy in severe sepsis method.