血液净化CVVH模式在感染性休克患者中的应用评价

Clinical observation of continuous veno - venous hemofiltration on patients with septic shock

目的 探讨血液净化连续静静脉血液滤过（CVVH）模式在感染性休克患者中的应用价值。 方法 回顾性分析西安交通大学第二附属医院急诊重症监护病房（EICU）收治的72例存活感染性休克患者，根据患者入院后是否行血液净化治疗，将所有患者分为治疗组和对照组。治疗组33例，对照组39例，收集两组患者血液净化前及治疗12 h后生命体征及相关生化指标进行比较。 结果 两组治疗前年龄、心率、去甲肾上腺素用量和血乳酸值等比较差异无统计学意义（P＞0.05），经12 h血液净化治疗后，患者心率、去甲肾上腺素用量及血乳酸值明显下降，ICU住院时间明显缩短，差异均有统计学意义（P均〈0.05）。 结论 感染性休克患者早期积极给予血液净化治疗可更加快速、有效的改善患者生命体征，降低血乳酸值，减少血管活性药物用量，改善患者组织灌注，缩短患者ICU住院时间。

Objective To investigatethe application of continuous veno - venous hemofihration （CVVH） therapy in the treatment of patients with sepsis shock. Methods Seventy two cases of sepsis shock patients were selected form emergency intensive care unit（EICU） in our hospital. All the patients were divided into observation group（ n = 33 ） and control group（ n = 39 ）. Control group were given the conventional treatment, however, the observation group were given the CVVH therapy. Symptom, pulse, the dosage of norepinephrine, lactic and ICU stay time were compared between the two groups. Results Compared the two groups, the age, pulse, the dosage of norepinephrine, lactic was of no statistical significant difference （P 〉 0.05 ）. After 12 hours CVVH therapy, the observation group had a decreased level of pulse, the dosage of norepinephrine, lactic and ICU stay time had a statistical significant difference （ P 〈 0.05 ）. Conclusion The CVVH therapy can effectively improve the sepsis shock patients clinical indicators, improve the inadequate tissue perfusion, shorten the patients ICU stay time.