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目的:探讨持续静脉血流滤过(CVVH)治疗在重症脓毒症治疗中的临床中的应用。方法:选择遵义市第一人民医院重症医学科36例重症脓毒症患者,均在常规治疗基础上行CVVH治疗,在CVVH治疗之前和之后分别记录病人的心率、呼吸、平均动脉压、中心静脉血氧饱和度、氧合指数、血乳酸(Lac)、降钙素、APACHEⅡ评分、呼吸机参数及多巴胺用量等。结果:经过连续性血液净化治疗,病人的生命体征逐渐趋于稳定,氧合指数、中心静脉血氧饱和度升高,血乳酸、降钙素原、APACHEⅡ评分下降。结论:连续静脉血液净化能改善重症脓毒症患者的血流动力学状况及肺氧合功能,稳定内环境,值得加以推广辅助治疗重症脓毒血症。
Objective: To investigate the clinical application of continuous venous hemofiltration (CVVH) in the treatment of severe sepsis. Methods: Thirty-six patients with severe sepsis in the Department of Critical Care Medicine, First People’s Hospital of Zunyi were enrolled and treated with CVVH on the basis of routine treatment. The heart rate, respiration, mean arterial pressure, central venous blood Oxygen saturation, oxygenation index, lactic acid (Lac), calcitonin, APACHE Ⅱ score, ventilator parameters and dopamine dosage and so on. Results: After continuous blood purification treatment, the patient’s vital signs gradually stabilized, the oxygenation index and central venous oxygen saturation increased, and the levels of serum lactate, procalcitonin and APACHEⅡ decreased. CONCLUSION: Continuous venous blood purification can improve hemodynamics and pulmonary oxygenation in patients with severe sepsis and stabilize the internal environment. It is worth to be promoted to assist in the treatment of severe sepsis.