摘要
目的 探讨连续性血液净化(CBP)对感染所致多脏器功能障碍综合征(MODS)患者血流动力学及氧代谢的影响。方法 选择感染所致MODS患者17例,应用连续静脉-静脉血液滤过(CVVH)联合血浆置换(PE)进行治疗,治疗期间用Swant-Ganz漂浮导管监测血流动力学变化并检测氧代谢指标。结果 与CBP前比较,CBP治疗后,体血管阻力指数(SWRI)明显改善,平均动脉压(MAP)回升,心率(HR)下降,肺动脉压及肺动脉楔压(PAP、PCWP)也明显降低,动脉血氧分压明显上升(P<0.01),氧供及氧耗均有所增加(P<0.05),动脉血乳酸含量明显降低(P<0.01),混合静脉血氧分压、静脉血氧饱和度及氧摄取率无明显变化(P>0.05)。结论 CBP可改善MODS患者的全身血流动力学状况,提高患者的氧供,但对氧摄取率无明显影响。
Objective To evaluate the effects of continuous blood purification on hemodynamics and oxygenation in patients with
multiple organ dysfunction syndrome. Methods 17 patients with MODS were selected and treated with CVVH combined with plasma exchange
(PE). Hemodynamics and oxygenation were measured or calculated at scheduled intervals by use of Swan-Ganz catheters. Results Indices
of systemic vascular resistance (SVRI), mean arterial pressure (MAP), partial pressure of arterial oxygen (PaO_2), oxygen delivery (DO_2),
oxygen consumption (VO_2) increased, heart rate (HR), mean pulmonary arterial pressure (MPAP), pulmonary capillary wedge pressure
(PCWP), blood lactate concentration decreased significantly and partial oxygen pressure in mixed venous blood (PvO_2), venous oxygen
saturation (SvO_2), oxygen extraction ratio (O_2ER) did not change after treatment. Conclusion Continous blood purification could increase
blood and oxygen supply. but it had no significant effects on oxygen extraction ratio of MODS patients.
出处
《中国急救医学》
CAS
CSCD
北大核心
2003年第11期760-761,共2页
Chinese Journal of Critical Care Medicine
基金
广东省中山市科技计划项目(No.2002 A023)
