连续性血液净化对严重脓毒症患者的治疗作用

目的探讨连续性血液净化（CBP）治疗对严重脓毒症患者疗效及预后的影响。方法选择严重脓毒症患者53例，随机分为对照组26例、CBP组27例，分别于治疗前及治疗24、72h后检测患者动脉血气分析、乳酸、肝肾功能和血常规，并采用APACHEII评分对患者整体病情进行评价，同时观察ICU住院时间、应用呼吸机时间及28d的病死率。结果与对照组相比，CBP组患者APACHE171评分减少，多器官功能衰竭发生率降低，氧合指数及血流动力学指标好转，血肌酐水平、28d病死率降低，ICU住院时间、应用呼吸机时问缩短，差异均有统计学意义（P〈0．05或0．01）。结论CBP对多个器官起支持作用，并能改善血流动力学指标，减轻脓毒症病情的严重程度，从而改善预后。

Treatment effects of continuous blood purification for patients with severe sepsis

Objective To investigate the effects of continuous blood purification （CBP） for the treatment of patients with severe sepsis. Methods A total of 53 septic patients was enrolled, and randomly divided into two groups, CBP group （n = 27） and control group（ n = 26）. In two groups, the APACHE Ⅱ score, death rate in 28 days, complication rate, hemodynamics, blood gas analysis, blood lactate and the level of blood creatinine, bilirubin were recorded before and after treatment and compared. Results Compared with control group, mean APACHE Ⅱ score, the rate of multiple organ failure, blood creatinine all decreased, oxygenation index and haemedynamics indexes improved（ P 〈 0.05 or 0.01 ）, length of stay in ICU and the use time of breathing machine were shorten, case fatality for 28 days decreased. Conclusions The CBP plays a supporting role to multiple organs and reduces the severity of the sepsis as well as improves the prognosis.