连续性静脉-静脉血液滤过对重症糖尿病乳酸性酸中毒患者APACHE-Ⅱ评分的影响

Effect of continuous venous-venous hemofiltration on APACHE-Ⅱscore in patients with severe diabetic lactic acidosis

目的探讨连续性静脉-静脉血液滤过(CVVH)对重症糖尿病乳酸性酸中毒患者急性生理和慢性健康(APACHE-Ⅱ)评分的影响。方法选取我院73例重症糖尿病乳酸性酸中毒患者,按治疗方案将其分为透析组(n=36)与滤过组(n=37)。透析组给予连续性静脉-静脉血液透析(CVVHD)治疗,滤过组给予CVVH治疗。比较两组治疗效果。结果滤过组患者的治愈率高于透析组,住院时间短于透析组(P<0.05)。治疗12 h后,滤过组患者的血乳酸水平低于透析组(P<0.05)。治疗12、24 h后,两组患者的APACHE-Ⅱ评分均降低,CO2结合力均升高,且滤过组均优于透析组(P<0.05)。结论CVVH治疗重症糖尿病乳酸性酸中毒能降低患者乳酸水平,缩短住院时间,提高CO2结合力,减轻患者病情。

Objective To investigate the effect of continuous venous-venous hemofiltration(CVVH)on acute physiology and chronic health(APACHE-Ⅱ)scores in patients with severe diabetic lactic acidosis.Methods A total of 73 patients with severe diabetic lactic acidosis in our hospital were selected,according to the treatment plan,the patients were divided into dialysis group(n=36)and filtration group(n=37).The dialysis group was treated with continuous venous-venous hemodialysis(CVVHD)and the filtration group was treated with CVVH.The treatment effects were compared between the two groups.Results The cure rate of the filtration group was higher than that of the dialysis group,and the hospitalization time was shorter than that of the dialysis group(P<0.05).After 12 h of treatment,the blood lactate level of the filtration group was lower than that of the dialysis group(P<0.05).After 12 and 24 h of treatment,the APACHE-Ⅱscores of the two groups decreased,the CO2 binding capacity increased,and those of the filtration group were better than the dialysis group(P<0.05).Conclusion CVVH in the treatment of severe diabetic lactic acidosis can reduce the lactate levels,shorten the length of hospital stay,improve CO2 binding capacity,and alleviate the patient's condition.