高容量血液滤过在脓毒症并发多器官功能障碍综合征中的应用

目的：探讨高容量血液滤过（HVHF）对脓毒症并发多器官功能障碍综合征（MODS）的疗效。方法：回顾性分析HVHF治疗的39例脓毒症并发MODS患者,对比分析死亡组和存活组的血浆IL-6,并比较HVHF治疗前和治疗24h后血肌酐（Cr）、尿素氮（BUN）、氧合指数、乳酸、平均动脉压（MAP）、APACHEⅡ评分。结果：经HVHF治疗后2组血浆IL-6均明显降低（P〈0.01）,但HVHF治疗前、后死亡组IL-6均明显高于存活组（P〈0.01）。经HVHF治疗24h后2组Cr、BUN、氧合指数、乳酸、MAP均明显改善（P〈0.01）;存活组APACHEⅡ评分显著降低（P〈0.01）。结论：HVHF可有效辅助治疗脓毒症并发MODS,有效清除血浆IL-6。

Application of High-volume Hemofiltration for Patients With Sepsis Complicated With Multiple Organ Dysfunction Syndrome

Objective：To investigate the therapeutic effect of high-volume hemofiltration（HVHF）for patients with sepsis complicated with multiple organ dysfunction syndrome（MODS）.Methods：Thirty-nine cases with sepsis complicated with MODS were studied retrospectively.Plasma level of interleukin-6（IL-6）was compared between death and survival group.Serum creatinine,blood urea nitrogen（BUN）,oxygenate index,lactic acid,mean arterial pressure,APACHE Ⅱscore were compared before and 24 hours after HVHF.Results：Serum IL-6 decreased significantly in two groups after HVHF（P0.01）,but the serum IL-6 were significantly higher in non-survival group than that in survival group before and after HVHF（P0.01）.Serum creatinine,BUN,oxygenate index,lactic acid and mean arterial pressure improved significantly in two groups 24 hours after HVHF（P0.01）.APACHE Ⅱ score decreased significantly in survival group（P0.01）.Conclusions：HVHF is an effective supportive measure for patients with sepsis complicating MODS,and it can eliminate IL-6 effectively.