CHVHF 治疗严重脓毒症合并多器官功能障碍综合征的 疗效及对血流动力学的影响

张良，张涛，卞康，武杜鹃

咸阳市中心医院，陕西 咸阳，712000

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摘要：

目的 探讨持续高容量血液滤过（CHVHF）治疗严重脓毒症合并多器官功能障碍综合征（MODS）的疗效及对血流动力学的影响。方法 选取我院收治的严重脓毒症合并 MODS患者 60例为研究对象，随机分为对照组和观察组，各 30例。对照组给予常规容量血液滤过（CVHF）治疗，观察组给予 CHVHF 治疗。比较两组患者的临床治疗效果。结果 治疗后，两组患者的体温、MODS评分及急性生理与慢性健康（APACHEⅡ）评分均明显低于治疗前，且观察组明显低于对照组（P<0.05）；治疗后，两组患者的心率（HR）及外周血管阻力指数（SVRI）水平均降低，有创动脉压（MAP）水平均升高，且观察组 HR 及 MAP 水平明显高于对照组，SVRI水平明显低于对照组（P<0.05）。结论 严重脓毒症合并 MODS患者给予 CHVHF 治疗，可稳定生命体征，改善血流动力学，值得临床推广应用。

关键词：持续高容量血液滤过（CHVHF）；常规容量血液滤过（CVHF）；脓毒症；多器官功能障碍综合征（MODS）；血流动力学

中图分类号：R459.7文献标志码：A文章编号：2096-1413(2018)09-0023-02

Clinical effect of CHVHF on severe sepsis complicated with multiple organ
dysfunction syndrome and its effect on hemodynamics

ZHANG Liang,ZHANG Tao,BIAN Kang,W U Du-juan
(XianyangCentralHospital,Xianyang712000,China)




ABSTRACT: Objective To investigate the clinical effect of continuous high volume hemofiltration (CHVHF) on severesepsis complicated with multipleorgan dysfunction syndrome (MODS) and itseffecton hemodynamics. Methods Sixty patients with severe sepsis complicated with MODS admitted in our hospital were selected and randomly divided into control group and observation group, with 30 casesin each group.The control group received conventional volume hemofiltration (CVHF), and the observation group was treated with CHVHF. The clinical effects of the two groups were compared. Results After treatment,the body temperature, MODS scores and acutephysical and chronic health (APACHEⅡ)scores of the two groups were lower than those before treatment,and those of the observation group were lower than the control group (P<0.05). After treatment,the levels of heartrate (HR)  and peripheral vascularresistance index (SVRI)of the two groups decreased, and the invasivearterial pressure(MAP)level increased in addition,the levels of HR and MAP of the observation group were higher than those of the control group,and the SVRI level was lower than that of the control group (P<0.05).Conclusion CHVHF applied in severe sepsis patients with MODS can stabilize vitalsigns,and improve hemodynamics, which is worthy of clinical popularization and application.
KEYWORDS: continuous high volume hemofiltration (CHVHF);conventional volume hemofiltration (CVHF);sepsis;multiple organ dysfunction syndrome(MODS); hemodynamics

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