摘要
目的观察持续血液滤过（CVVH）与血液灌流（HP）联合治疗重症脓毒血症的临床疗效及对炎性因子的影响和对脏器功能的保护作用。方法将2013年10月-2014年12月我院治疗的重症脓毒血症患者88例随机分为两组,对照组44例采用CVVH治疗,观察组44例采用CVVH加HP治疗,观察比较两组治疗前后的生命体征、炎性因子水平、脏器功能指标以及急性生理学及慢性健康状况评分（APACHEⅡ）和全身性感染相关性器官功能衰竭（SOFA）评分的变化情况。结果观察组治疗后呼吸、心率、体温均较本组治疗前和对照组治疗后明显降低,平均动脉压较本组治疗前和对照组治疗后明显升高（P〈0.05）。观察组治疗后血清白介素-6（IL-6）、白介素-10（IL-10）、肿瘤坏死因子（TNF-α）、C反应蛋白（CRP）水平均较本组治疗前和对照组治疗后有明显降低（P〈0.05）,治疗后ALT、Scr以及APACHEⅡ评分、SOFA评分均较本组治疗前和对照组治疗后明显降低（P〈0.05）。结论 CVVH联合HP治疗重症脓毒血症疗效显著,能够有效降低患者炎性因子水平,改善其脏器功能。
Objective To observe the clinical effects of continuous veno-venous hemofiltration（CVVH） combined with hemoperfusion（HP） on severe pyemia and its influence on inflammatory factors and protection for organ function. Methods 88 cases of severe pyemia that had received the treatment between October 2013 and December 2014 were equally and randomly divided into two groups. Control group was treated by CVVH, and observation group was treated by CVVH plus HP. Observation and comparison were made in the changes of vital signs, the levels of inflammatory factors, organ function indexes, acute physiology and chronic health evaluation（APACHE Ⅱ） scores, and scores by sepsis-related organ failure assessment（SOFA） between the two groups before and after the treatment. Results The respiration, heart rate, and temperature after the treatment in the observation group were significantly lower than those before the treatment and those in the control group after the treatment. The arterial pressure after the treatment in the observation group increased significantly than that before the treatment and that in the control group after the treatment（P 〈0.05）. The serum interleukin-6（IL-6）, interleukin-10（IL-10）, tumor necrosis factor alpha（TNF-α）, C reactive protein（CRP） levels of the observation group after the treatment decreased significantly compared with those of the group before the treatment and those of the control group after the treatment（P 〈0.05）. And after the treatment, ALT, Scr, APACHE Ⅱscores, and SOFA scores of the observation group decreased significantly compared with those of the group before the treatment and those of the control group after the treatment（P 〈0.05）. Conclusion CVVH combined with HP have significant curative effects on severe pyemia, which can effectively reduce the level of inflammatory factors and improve the function of organs.
出处
《西南国防医药》
CAS
2015年第10期1066-1069,共4页
Medical Journal of National Defending Forces in Southwest China
