高容量血液滤过对严重乳酸酸中毒患者的救治

Treatment of Serious Lactic Acidosis with High Volume Hemofiltration

目的观察高容量血液滤过(HVHF)对严重乳酸酸中毒患者的治疗效果。方法选择2010年1月至2014年10月期间入住我院ICU符合乳酸酸中毒的重症患者48例为研究对象,根据治疗时间将患者分为对照组(2010年1月至2012年12月)和HVHF组(2013年1月至2014年10月)。对照组(25例)采用常规综合治疗,HVHF组(23例)在常规治疗基础上采用HVHF进行治疗。比较两组患者治疗前以及治疗24 h、72 h后血乳酸、动脉血p H值、APACHEⅡ值的变化情况,并记录两组患者的14天病死率。结果治疗24 h、72 h后,两组患者血乳酸、动脉血p H值、APACHEⅡ值均明显改善,且HVHF组改善程度显著优于对照组;HVHF组14天病死率显著低于对照组,差异均具有统计学意义(P<0.05)。结论高容量血液滤过对严重乳酸酸中毒患者疗效确切,能够改善患者病情,降低近期病死率。

Objective To observe the treatment effect of high volume hemofiltration（HVHF） on patients with severe lactic acidosis.Methods 48 critical patients with lactic acidosis admitted to ICU in our hospital from January 2010 to October 2014 were selected as objects and divided into control group（from January 2010 to December 2012） and HVHF group（from January 2013 to October 2014） according to the treatment time. The control group（25 cases） was given conventional and comprehensive therapy, the HVHF group（23 cases） was given HVHF on the basis of conventional therapy. The conditions of blood lactic acid, arterial blood p H, APACHE Ⅱvalue 24 h, 72 h before and after the treatment in two groups were compared, the 14-day mortality of two groups was recorded. Results After 24 h and 72 h of the treatment, the blood lactic acid, arterial blood p H, APACHE Ⅱ value of two groups were significantly improved, and the improvement degree of HVHF group was better than that of control group; the 14-day mortality of HVHF group was significantly lower than that of control group; both the difference was statistical（P〈0.05）. Conclusions HVHF has definite effect on patients with severe lactic acidosis, which can improve patients＇ conditions and reduce the short-term mortality.