高容量血液滤过对脓毒症的治疗研究

目的探讨高容量血液滤过技术对脓毒症患者的治疗作用。方法13例病人随机分为滤过组6例和对照组7例。两组均予常规治疗。滤过组患者行高容量血液滤过,置换液流量为(2000～3000)mL/h,血流量为(80～120)mL/min,每天持续进行10h以上。两组于治疗前、治疗后48h进行急性生理与慢性健康评分Ⅱ,记录心率、平均动脉压,检测肿瘤坏死因子α、白细胞介素-6。结果治疗后两组患者急性生理与慢性健康评分Ⅱ均下降(P0.05),滤过组治疗后48h下降更为明显(P0.05),滤过组治疗后心率明显降低,平均动脉压明显升高,肿瘤坏死因子α、白细胞介素-6明显下降(P0.05)。对照组的相关指标于治疗前后均无显著改变(P0.05)。结论高容量血液滤过有助于血流动力学稳定,清除部分炎症因子,有利于减轻脓毒症病情。

Treatment of Sepsis Patients by High Volume Hemofiltration

Objective To investigate the effect of high volume hemofiltration （HVHF）on sepsis patients. Methods Thirteen patients were divided randomly into HVHF group（with 6 in it） and control group（with 7 in it）, and both groups received regular treatment, received high volume hemofiltration was added to the HVHF group for more than 10h daily. The replacement flow rate was（2000=3000）mL/h and the blood flow rate was（80- 120）mL/min. Acute physiology and chronic health evaluation（APACHE U ）, heart rate（HR）, mean artery pressure（MAP）, tumor necrosis factor α （TNF-α ）and interleukin-6（IL-6）were recorded. Results APACHE II was decreased after treatment in both groups （P〈0.05）,with a significant decrease after 48h treatment in the HVHF group. HR,TNF-α and IL-6 were decreased and MAP was elevated after treatment in the HVHF group significantly（P〈0.05）. No significant changes of these parameters were found in the control group（P〉 0.05 ）. Conclusion HVHF helps to stabilize hemodynamics, remove inflammatory factors, and ameliorate sepsis.