【摘要】 目的观察不间断连续性血液净化(CBP)治疗严重脓毒症并毛细血管渗漏(CLS)的疗效。方法按随机原则将严重脓毒症并出现毛细血管渗漏患者分为常规对照组25例和治疗组25例,两组患者均按2012严重脓毒症和脓毒症休克治疗指南的早期集束化治疗方案进行治疗,常规对照组采用间断连续性静-静脉血液滤过(CVVH),每日治疗12小时;治疗组不间断连续性血液净化治疗,分别于治疗前及治疗24、48、72h后行动脉血气分析,观察患者ICU住院时间、机械通气时间及28d病死率。结果治疗组ICU住院时间及机械通气时间均显著低于常规对照组(P<0.05),28d病死率明显低于常规对照组(P<0.05),治疗72h后,治疗组APACHEII评分均明显下降,治疗组治疗后24、48、72h氧合指数均较治疗前明显增高(P<0.05),且较常规对照组(24、48、72h)同期明显增高(P<0.05)。结论不间断连续性血液净化治疗能明显减轻严重脓毒症患者毛细血管渗漏,改善预后。更多还原

【Abstract】 Objective: to observe the curative effect of the continuous blood purification(CBP) in the treatment of severe sepsis with capillary leak syndrome(CLS). Methods The patients with such disease wererandomly divided into control group and treatment group, 25 samples in each, treated in accordance with the early Bundle of the severe sepsis and septic shock treatment guidelines in 2012. The control group were treated with CVVH, 12 hours a day; yet the treatment group with CBP, taking arterial blood gas analysis before and at the 24 h, 48 h and 72 h after the treatment, to observe the length of ICU stay, mechanical ventilation time and 28 d fatality rate. Results: the length of ICU stay, mechanical ventilation time and 28 d fatality rate of the treatment group were significantly shorter than the control group(P<0.05). 72 h after treatment, the APACHE II scores of the treatment group were significantly decreased with the increased oxygenation index of 24 h, 48 h and 72 h than before(P<0.05), significantly higher than those of the control group(24h, 48 h, 72 h respectively)(P<0.05). Conclusion: CBP treatment can obviously relieves the capillary leakage symptom of patients with severe sepsis, improving the prognosis.更多还原