摘要
目的探讨连续性血液净化治疗烧伤后高钠血症的治疗效果。方法回顾性分析24例接受连续性静脉-静脉血液滤过(CVVH)治疗的重症烧伤后高钠血症患者的临床资料。高钠血症诊断标准:1天内连续2次外周静脉血钠浓度>150mmol/L。治疗使用床旁连续性血液净化治疗机,抗凝使用低分子肝素或无肝素。置换液为前置换,置换液流量2～4L/h。测定治疗前后心率、体温、平均动脉压、氧饱和度、氧合指数、碳酸氢根、血肌酐、尿素氮、血钠、血乳酸等。结果 24例烧伤后高钠血症患者中存活11例。经CVVH治疗后,患者体温、心率降低,平均动脉压提高,血氧改善,血尿素氮、肌酐水平较治疗前明显降低。血钠从第6小时后逐渐下降,治疗前后血钠比较[(163.3±9.1)mmol/L:(146.4±2.3)mmol/L];置换液前后比较(149.8±5.6)mmol/L:(142.0±2.1)mmol/L]差异显著。结论 CVVH用于救治烧伤后高钠血症的患者疗效确切,在纠正高钠血症同时,可提高肺换气功能,稳定水、电解质及酸碱平衡。早期治疗可能取得更好的疗效。
Objective To observe the therapeutic effect of continues blood purification in burnt patients with hyper- natremia. Methods Blood sodium 〉 150mmol/L two times in one day was defined hypernatremia. Total 24 burnt patients with hypernatremia received CVVH, Replacement solution infused rate was 2 -4L/h. Before and after CV- VH,level of the HR, TEM, MAP, SPO2, PaO2/FiO2, HCO3- , LAC and main biochemical indicator in plasma were all measured. Results 11 of 24 patients were survived~ After CVVH ,the level of the HR ,TEM ,Bun,Scr,and LAC decreased obviously （ P 〈 0.01 ）. MAP, PaO2/FiO2, were significantly higher than the pretherapy （ P 〈 0.01 ）. Before and after CVVH, Blood sodium level was [ （ 163.3±9.1 ） mmol/L vs. （ 146.4 ±2.3 ） mmo]/L, P 〈 0.01 ]. Conclusion CVVH play an important role in the therapy of burnt patients with hypernatremia,which can improve the air exchange function of lung and keep the stability of water-electrolyte and acid - base. Early intervent with CVVH in a eritieally burn population with hypernatremia, and maybe get better survival. Key words： Continues blood purification ; Burns ; Hypernatremia
出处
《中国医刊》
CAS
2010年第5期34-36,共3页
Chinese Journal of Medicine
关键词
连续性血液净化
烧伤
高钠血症
Continues blood purification
Burns
Hypematremia
