中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015年
5期
521-523
,共3页
陈波%冯玉峰%温顺%赵宏胜%叶宏伟%王佳佳
陳波%馮玉峰%溫順%趙宏勝%葉宏偉%王佳佳
진파%풍옥봉%온순%조굉성%협굉위%왕가가
血液灌流%血液滤过%脓毒性休克%血管外肺水%心排血指数%外周血管阻力指数
血液灌流%血液濾過%膿毒性休剋%血管外肺水%心排血指數%外週血管阻力指數
혈액관류%혈액려과%농독성휴극%혈관외폐수%심배혈지수%외주혈관조력지수
Hemoperfusion%Hemofiltration%Septic shock%Extra-vascular lung water%Cardiac index%System vascular resistance index
目的 探讨连续性静-静脉血液滤过(CVVH)联合血液灌流(HP)对脓毒性休克患者的治疗作用.方法 采用前瞻性研究方法.将江苏省常熟市第一人民医院收治的32例脓毒性休克患者按随机数字表方式分为两组,观察组(17例)在CVVH之前加用HP,对照组(15例)仅进行CVVH治疗,两组均连续治疗5 d.于治疗前及治疗后5 d观察两组患者脉搏血氧饱和度(SpO2)、中心静脉压(CVP)、外周血管阻力指数(SVRI)、心排血指数(CI)、血管外肺水指数(EVLWI)的变化.结果 两组治疗后SpO2、CVP、SVRI、CI水平均较治疗前明显升高,EVLWI较治疗前降低,且观察组上述指标的变化程度较对照组同期更加显著〔SpO2:0.966±0.035比0.939±0.036,CVP(mmHg,1 mmHg=0.133 kPa):8.5±3.2比8.1±4.2,SVRI(kPa·s·L-1·m-2):1 497.35±157.08比1 343.60±144.48,CI(mL·s-1·m-2):120.36±15.34比106.69±12.33,EVLWI(mL/kg):6.84±0.73比7.65±0.70,均P<0.05〕.结论 HP联合CVVH较单纯CVVH对改善脓毒性休克患者的疗效更好.
目的 探討連續性靜-靜脈血液濾過(CVVH)聯閤血液灌流(HP)對膿毒性休剋患者的治療作用.方法 採用前瞻性研究方法.將江囌省常熟市第一人民醫院收治的32例膿毒性休剋患者按隨機數字錶方式分為兩組,觀察組(17例)在CVVH之前加用HP,對照組(15例)僅進行CVVH治療,兩組均連續治療5 d.于治療前及治療後5 d觀察兩組患者脈搏血氧飽和度(SpO2)、中心靜脈壓(CVP)、外週血管阻力指數(SVRI)、心排血指數(CI)、血管外肺水指數(EVLWI)的變化.結果 兩組治療後SpO2、CVP、SVRI、CI水平均較治療前明顯升高,EVLWI較治療前降低,且觀察組上述指標的變化程度較對照組同期更加顯著〔SpO2:0.966±0.035比0.939±0.036,CVP(mmHg,1 mmHg=0.133 kPa):8.5±3.2比8.1±4.2,SVRI(kPa·s·L-1·m-2):1 497.35±157.08比1 343.60±144.48,CI(mL·s-1·m-2):120.36±15.34比106.69±12.33,EVLWI(mL/kg):6.84±0.73比7.65±0.70,均P<0.05〕.結論 HP聯閤CVVH較單純CVVH對改善膿毒性休剋患者的療效更好.
목적 탐토련속성정-정맥혈액려과(CVVH)연합혈액관류(HP)대농독성휴극환자적치료작용.방법 채용전첨성연구방법.장강소성상숙시제일인민의원수치적32례농독성휴극환자안수궤수자표방식분위량조,관찰조(17례)재CVVH지전가용HP,대조조(15례)부진행CVVH치료,량조균련속치료5 d.우치료전급치료후5 d관찰량조환자맥박혈양포화도(SpO2)、중심정맥압(CVP)、외주혈관조력지수(SVRI)、심배혈지수(CI)、혈관외폐수지수(EVLWI)적변화.결과 량조치료후SpO2、CVP、SVRI、CI수평균교치료전명현승고,EVLWI교치료전강저,차관찰조상술지표적변화정도교대조조동기경가현저〔SpO2:0.966±0.035비0.939±0.036,CVP(mmHg,1 mmHg=0.133 kPa):8.5±3.2비8.1±4.2,SVRI(kPa·s·L-1·m-2):1 497.35±157.08비1 343.60±144.48,CI(mL·s-1·m-2):120.36±15.34비106.69±12.33,EVLWI(mL/kg):6.84±0.73비7.65±0.70,균P<0.05〕.결론 HP연합CVVH교단순CVVH대개선농독성휴극환자적료효경호.
Objective To explore the therapeutic effect of combining continuous venovenous hemofiltration (CVVH) with hemoperfusion (HP) on patients with septic shock.Methods A prospective study was conducted. Thirty-two patients with septic shock admitted to Changshu No.1 People's Hospital were enrolled, and they were divided into two groups according to random digits table. The observation group (17 cases) was given HP before CVVH, in the control group (15 cases), only CVVH treatment was carried out, and lasting for 5 days in both groups. The changes of pulse oxygen saturation (SpO2), central venous pressure (CVP), systemic vascular resistance index (SVRI), cardiac index (CI), extra-vascular lung water index (EVLWI) were observed before treatment and 5 days after treatment.Results Compared with those before treatment, the levels of SpO2, CVP, SVRI, CI were obviously elevated, and EVLWI was markedly decreased after treatment in two groups. Compared with those of control group, the degrees of improvement of above indicators in observation group were more prominent [SpO2: 0.966±0.035 vs. 0.939±0.036, CVP (mmHg, 1 mmHg = 0.133 kPa): 8.5±3.2 vs. 8.1±4.2, SVRI (kPa·s·L-1·m-2): 1 497.35±157.08 vs. 1 343.60±144.48, CI (mL·s-1·m-2): 120.36±15.34 vs. 106.69±12.33, EVLWI (mL/kg): 6.84±0.73 vs. 7.65±0.70, allP < 0.05].Conclusion Combing HP with CVVH for treatment of patients with septic shock can improve their prognosis more obviously than using CVVH alone.
