连续性血液净化抢救严重脓毒症患者的临床评价

目的研究连续性血液净化(Continous Blood Purification,CBP)治疗严重脓毒症患者的临床疗效。方法选择84例严重脓毒症患者,随机分为:常规治疗组(对照组)44例,常规治疗+CVVH组(观察组)40例,分别观察两组患者生命体征、动脉血气分析、血乳酸水平、血生化、血常规和凝血功能。结果观察组患者氧合指数、血流动力学指标、血肌酐、APACHEⅡ评分、多器官功能衰竭发生率、机械通气时间、ICU住院时间、死亡率与对照组比较差异均有统计学意义(p<0.05或0.01)。结论在常规治疗的基础上加用连续性血液净化治疗严重脓毒症,能有效清除患者致炎介质和毒素,维持内环境稳定,改善氧合功能及血流动力学指标,提高抢救成功率。

CLINICAL EFFICACY ABOUT CONTINUOUS BLOOD PURIFICATION(CBP) TREATMENT IN PATIENTS WITH SEVERE SEPSIS

Objective To study the clinical efficacy about continuous blood purification （CBP） treatment in patients with severe sepsis. Methods 84 patients with severe sepsis were randomly divided into： the control group consisted of 44 patients who received only routine therapv, the observation group consisted of 40 patients who received routine therapv＋ CVVH. To difference between observation and control groups in vital signs, arterial blood gas anal- ysis, blood lactate level, blood biochemistry, blood routine and coagulation function. Results There were statistical differences in oxygenation index, hemodynamic parameters, serum creatinine level, APACHE II scores, the multiple organ failure rate, duration of mechanical ventilation, ICU hospitalization time and the mortality rate between observa- tion and control groups （p 〈 0. 05 or 0. 01 ）. Conclusion Continuous blood purification treatment in patients with se- vere sepsis on the basis of routine therapy, could effectively remove proinflammatory mediators and poison, maintain the homeostasis, markedly improve oxygenation and hemodynamics, and therefore increase the successful rate of resus- citation.