间歇性高容量血液滤过治疗严重脓毒症急性肾损伤的疗效观察.pdf

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1、·520·亘医结合肾病杂志2015年6月第16卷第6期CJITWN。June2015．Vo1．16．No．6·短篇论著·间歇性高容量血液滤过治疗严重脓毒症急性肾损伤的疗效观察袁丽萍①陈秋莲①罗敏虹①林茴①曾海鸥①陈圳炜①朱浪静①[摘要]目的：探讨间歇性高容量血液滤过(PHVHF)治疗严重脓毒症急性肾损伤(SAKI)的疗效。方法：我院ICU2011年6月～2014年10月收治的SAKI患者40例，随机分为对照组和治疗组，两组患者均为2O例。治疗组给予HVHF6oml·kg。。·h每日治疗8～13h，对照组给予CVVH30ml·kg～·

2、h治疗24～72h，必要时重复治疗时间，观察治疗前、后两组SAKI患者急性生理学与慢性健康状况(APACHE)Ⅱ评分、血流动力学指标、血清中肿瘤坏死因子d(TNF—Ot)和白细胞介素一6(IL一6)、血白细胞、C反应蛋白指标、肾功能开始改善时间、ICU住院时间以及60d生存率。结果：治疗后PHVHF组惠者的APACHElI评分、血清中TNF一0【和IL一6、血白细胞、c反应蛋白指标、肾功能改善时间、ICU住院时间、60d生存率与CVVH组差异无统计学意义(P>0．05)，CVVH组血流动力学指标较PHVHF组差异有统计学意义(P<0

3、．05)。结论：PHVHF可作为治疗SAKI的有效治疗手段，且经济实用，减少费用、耗材及人力成本。(关键词]间歇性高容量血液滤过严重脓毒症急性肾损伤ClinicalObservationonIntermittentHighVolumeHemofdtrationTreatmentofSepticAcuteKidneyInjuryYUANLiping，CHENQiulian，LUOMinhong，etalDepartmentofNephrology，theFourth(Futian)People’SHospitalofShenzhenA

4、ffiliatedtoGuangdongMedicalCollege，Shenzhen(518033)ABSTRACTObjective：Toinvestigatethetreatmentefectivenessofintermittenthish—volumehemofihration(PHVHF)inpatientswithsepticacutekidneyinjury(SAKI)．Methods：SAKIpatientsinourhospitalofICUformJune201ltoOctober2014weretreated

5、40caseswererandomlydividedintocontrolandtreatmentgroups．twogroupsofpatientswere20cases．，I1letreatmentgroupreceivedHVHF60ml·kg一。·h一’dailytreatment8～13h．thecontrolgroupreceivedCVVH30ml·kg一·h一treatment24～72h，ifnecessary，repeatthetreatmentperiod，observedbeforetreatment，aft

6、ertwoSAKIgroupofpatientswithacutephysiologyandchronichealthevaluation(APACHE)IIscore，hemodynamicparameters，senlmtumornecrosisfactor一0【(TNF—Ot)andinterleu·kin一6(IL一6)，whitebloodcells，C—reactiveproteinindicatorsofrenalfunctionbegantorecovertime，ICUlengthofstayand60dsurvi

7、va1．Results：GroupofpatientsaftertreatmentPHVHFAPACHEⅡscore，serumTNF一andIL一6，whitebloodcell，neutrophilproportion(deleted)，C—reactiveproteinindicatorsofrenalfunctionrecoverytime，ICUlengthofstay，60dsurvivalandCVVHgroupnodiference(P>0．05)，CVVHgrouphemodynamicsPHVHFstatisti

8、callysignificant(P<0．05)thangroup．Con一~lusion：PHVHFcanbeusedasanefectivetreatmentforthetreatmentofSAKI，andeconomical，