摘要
目的探讨高容量血液滤过(HVHF)对老年脓毒症血流动力学和氧代谢的影响。方法 85例老年脓毒症患者,每日行HVHF治疗12～18 h,观察HVHF治疗前(0 h)和治疗(24、48、72 h)后患者心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、心排血量(CO)、外周循环阻力(SVR)、肺循环阻力(PVR)、平均肺动脉压(MPAP)、肺动脉楔压(PAWP)、血氧合指数(PaO2/FiO2)、氧输送(DO2)、氧消耗(VO2)、氧摄取率(O2ER)、急性生理与慢性健康评分Ⅱ(A-PACHEⅡ)、序贯器官衰竭评估(SOFA)的变化。结果 HVHF治疗72 h内,存活65例,存活率76.5%。HVHF治疗48～72 h后患者的HR、MAP、CVP、CO、SVR、PVR、MPAP、PaO2/FiO2、DO2、VO2、O2ER,APACHEⅡ和SOFA评分与治疗前差异均有统计学意义(P<0.05)。结论 HVHF可以提高老年脓毒症患者的存活率,改善老年脓毒症的血流动力学和氧代谢,降低患者的APACHEⅡ和SOFA评分。
Objective To investigate the effect of continuous high volume hemofiltration（HVHF） on the hemodynamics and oxygen metabolism in elderly patients with sepsis. Methods Eighty-five elderly patients with sepsis received HVHF for 12 - 18 hours every day. Heart rate （HR） , mean arterial pressure （MAP） , central venous pressure （CVP） , cardiac output （ CO ） , systemic vascular resistance （ SVR）, pulmonary vascular resistance （ PVR ）, mean pulmonary arterial pressure （ MPAP ）, pulmonary artery wedge pressure （PAWP）, oxygenation index（ PaO2/FiO2 ）, oxygen delivery （DO2 ）, oxygen consumption （VO2 ）, oxygen extraction rate （02 ER） , acute physiology and chronic health evaluation l] （APACHE Ⅱ ） , sequential organ failure assessment （SOFA） were observed before and after the treatment at 24,48,72 hours. Results All 65 cases survived and the mortality rate was 76.5%. HR, MAP, CVP, CO, SVR, PVR, MPAP, PaOE/FiO2, DO2, VO2,02 ER, APACHE Ⅱ and SOFA were improved significantly after 48 to 72 hours of HVHF in patients （ P 〈 0.05 ）. Conclusion HVHF can improve the mortality rate and can improve hemody-namics and oxygen metabolism and lowers the scores of APACHE Ⅱ and SOFA in elderly patients with sepsis.
出处
《中华全科医学》
2013年第2期200-201,共2页
Chinese Journal of General Practice
关键词
高容量血液滤过
老年人
脓毒症
血流动力学和氧代谢
High volume hemofiltration
Elderly patients
Sepsis
Hemodynamics
Oxygen metabolism
