连续性血液净化对感染性休克患者血流动力学及氧合指数的影响

目的观察连续性血液净化(CBP)对感染性休克患者血流动力学及氧合指数的影响。方法我科确诊的25例感染性休克患者行CBP治疗及脉搏波形心排量监测(PICCO)72小时,治疗前和治疗后1、2、6、12、24、48、72小时分别测量持续心排量指数(CCI),外周血管阻力指数(SVRI)等血流动力学参数,同时检测动脉血气分析计算氧合指数,记录心率(HR)、有创平均动脉压(MAP)及去甲肾上腺素(NA)剂量的变化。结果治疗前、后血流动力学指标MAP、CCI、SVRI及氧合指数(OI,PaO2/FiO2)均有明显的改善(P0.05),在48及72小时改善尤为明显(P0.01),同时伴随去甲肾上腺素剂量的下降。结论 CBP可改善感染性休克患者血流动力学参数及氧合指数。

Effects of continuous blood purification on hemodymanics and oxygenation index in patients with septic shock

Objective To evaluate the effects of continuous blood purification（CBP） on hemodynamics and oxygenation index in patiants with septic shock.Methods Twenty-five patients with septic shock were selected and treated with continuous veno-venous hemofiltration（CVVH）.Hemodymanics parameter as continuous cardiac output index（CCI） and systemic vascular resistance index（SVRI） were measured by pulse indicator continous cardica output（PICCO）.Oxygenation index,heart rate,mean arterial pressure（MAP）,PaO2 and the dosage of noradrenaline（NA） were detected and recorded before treatment and in 1h,2h,6h,12h,24h,48h and 72h after treatment.Results MAP,CCI,SVRI,PaO2/FiO2 were improved after treatment（P 0.05）,especially in 48h and 72h（P 0.01）.The dosage of NA decreased simultaneously.Conclusion Hemodynamics and oxygenation index can be improved by CBP.