CAJ | 학술논문

目的观察连续性血液净化（ CBP ）对合并心肌损伤的感染性休克患者心功能及组织灌注的影响。方法选择40例合并心肌损伤的感染性休克患者行连续性静脉静脉血液滤过治疗，治疗期间用PiCCO监测记录血管外肺水指数（ EVLWI）肺血管通透指数（ PVPI）及反映心功能的指标脑利钠肽、肌钙蛋白I与组织灌注指标水平的变化。结果随着治疗时程的延长，患者血管外肺水指数与肺血管通透指数指数明显下降（P＜0.01），心功能指标脑利钠肽及肌钙蛋白I有明显下降（P＜0.01），组织灌注的指标血乳酸（Lac）、中心静脉血氧饱和度（Sc-VO2）、动静脉二氧化碳分压差（ P（ cv-a） CO2）有明显下降（ P＜0.01）。结论 CBP可改善合并心肌损伤的感染性休克患者心功能及组织灌注水平。
목적관찰련속성혈액정화（ CBP ）대합병심기손상적감염성휴극환자심공능급조직관주적영향。방법선택40례합병심기손상적감염성휴극환자행련속성정맥정맥혈액려과치료，치료기간용PiCCO감측기록혈관외폐수지수（ EVLWI）폐혈관통투지수（ PVPI）급반영심공능적지표뇌리납태、기개단백I여조직관주지표수평적변화。결과수착치료시정적연장，환자혈관외폐수지수여폐혈관통투지수지수명현하강（P＜0.01），심공능지표뇌리납태급기개단백I유명현하강（P＜0.01），조직관주적지표혈유산（Lac）、중심정맥혈양포화도（Sc-VO2）、동정맥이양화탄분압차（ P（ cv-a） CO2）유명현하강（ P＜0.01）。결론 CBP가개선합병심기손상적감염성휴극환자심공능급조직관주수평。
Objective To observe the effects of CBP on cardiac function and tissue perfusion in patients with septic shock complicated myocardial injury.Methods 40 patients merged myocardial injury with septic shock were treated with CVVH.EVLWI and PVPI were measured or calculated at scheduled intervals using PiCCO , and at the same time recor-ded the changes of the parameters of reflection of cardiac function that BNP , cTnI as well as tissue perfusion lev-el.Results With the extension of the schedule , EVLWI and PVPI of the patients decreased obviously ( P<0.01 ) , the level of BNP and cTnI had significantly lower (P<0.01), the parameter of tissue perfusion that Lac , ScVO2, P (CV-a) CO2 had significantly lower (P<0.01).Conclusions Cardiac function and tissue perfusion of the patients merged myocardial injury with septic shock can benefit from the treatment of CBP.