连续性血液净化治疗尿脓毒血症导致多器官功能障碍综合征临床探讨.docVIP

精品论文 参考文献 连续性血液净化治疗尿脓毒血症导致多器官功能障碍综合征临床探讨 克东县中医院 164800 摘要：目的 研究分析连续性血液净化治疗尿脓毒血症导致多器官功能障碍综合征（MODS）16例临床效果观察。方法此次研究的对象是选择2014年2月～2015年2月我院收治的16例尿脓毒血症并发MODS患者行连续性血液净化治疗，观察对比治疗前后的生命体征变化、肝肾功能、电解质、病情及血浆炎性介质的变化。结果 相较于治疗前，16例患者经CBP治疗72h后，其MAP、SpO2水平均明显升高，R、HR及APACHEⅡ评分均明显降低，Plt;0.05；且治疗后的肝肾功能、电解质变及血浆炎性介质观察指标均明显降低，Plt;0.05。结论 对尿浓毒血症致MODS患者应用CBP治疗，可有效改善患者生命体征，并可稳定机体内环境，清除血浆中的炎性介质，进而可改善病情。 关键词：连续性血液净化；尿脓毒血症；多器官功能障碍综合征 Abstract：Objective To study the analysis of continuous blood purification treatment for urinary sepsis leads to multiple organ dysfunction integrated syndrome（MODS）and 16 cases of clinical effect observation. Methods the study object is choose February 2014 to 2015 2 months in our hospital from 16 cases of urinary sepsis and MODS were treated with continuous blood purification treatment，observed and compared before and after treatment changes in vital signs，liver and kidney function，electrolyte，disease and plasma inflammatory medium change. Results compared with before treatment，16 patients after CBP treatment 72h，map，SpO2 levels were significantly elevated，R，HR，and APACHE II score were significantly decreased，P lt; 0.05；and after treatment of liver and kidney function，electrolytes and plasma inflammatory medium were observed were significantly lower（P lt; 0.05）. Conclusion on urinary sepsis induced MODS patients were treated by CBP，effectively improve the patients vital signs，and stable internal environment of body，remove inflammatory mediators in plasma，which can improve the condition. Keywords：continuous blood purification；urinary sepsis；multiple organ dysfunction syndrome 尿脓毒血症是一种由尿路感染所引发的全身炎症反应综合征，炎症介质常随血流扩散到其他组织器官中，并形成新的化脓性病灶，易并发多脏器器官功能障碍综合征（MODS），增加临床病死率。连续化血液净化（CBP）可清除体内炎性介质，对阻滞炎性介质扩散、疾病向更为严重的脓毒血症进展有重要的临床价值[1]。为此本文将对近年我院收治的16例尿脓毒血症并发MODS患者行CBP治疗，取的满意疗效，现报道如下。 1资料与方法 1.1一般资料 选择2014年2月～2015年2月我院收治的16例尿脓毒血症并发MODS患者，其中男10例，女6例；年龄28～82岁，平均（45.2plusmn;2.1）岁；原发病：急性肾盂肾炎7例，急性膀胱4炎，肾周围炎3例，外科手术术后并发尿路感染2例。所有患者均符合美国胸科医师学会/危重病医学会（ACCP/SCCM）