高容量血液滤过对严重创伤后血浆炎性介质及血流动力学的影响.pdfVIP

• 868 • 中国急救医学2ω8 年 10 月第28 卷第 10 期 Chin J Crit car慧 Med.ÜCL2∞8.VoL28.Nι10 高容量血液滤过对严重创伤后血浆炎性介质及 血流动力学的影响 向强，文亮，刘明华， 熊建琼，徐世伟 作者单位:4侃1038 重庆，解放军第三军医大学西南医院急救部 作者简介:向 强(1972 斗，男，主治医师，博士，主要从事创伤、急救的临床和实验研究。 [摘要] 目的 研究高容量血液滤过(HVHF) 对严重创伤后血浆炎性介质及血流动力学的影 响。方法 选择2∞4-06-2∞7 -03 我科收治的严重多发伤患者 32 例为研究对象，行 HVHF 治 疗，放置 Swan - G皿摞浮导管，测定滤过前后血浆炎性介质水平和血流动力学的变化。结果 与 滤过前比较，滤过后 TNF-α、 IL-Iß 、 IL - 6 ， C 反应蛋白(CRP) 水平均明显降低，MAP、 SVRI 、 CVP， CI 均无明显变化。结论 HVHF 可显著降低严重创伤患者血液中炎性介质的水平，对血流动力学 状态无明显影响。 [关键词] 高容量血液滤过; 创伤z 炎症反应E 血流动力学 [申图分类号] R 641 [文献标识码] A [文章编号] 1002 -1949(2鹏)10-侃侃-03 Efftωs of high volume hemoßltratio.o ( IIVHF) 0.0 肘asma inftammaωry cytokine and hemodyna皿α io the patieots after severe trauma XIANG Qiang , WEN μang， llU Ming - h凶， et al. Departmerú 01 Emerger町y， Southwestem Hospital , the Third Müitary Medïcal University , Chongqing 4αX38 ， China [ Abstract] Objective To study the effects of high volume hemofiltration ( HVHF) on plasma in- flammatory cytokine and hemodynamics in the patients after 回vere trauma. Methods From June 2∞4 to March 2∞7 ， 32 patients with severely multiple trauma were selected and treated with HVHF. Plasma in- flammat。可 cytokine and hemodynamics were measur哩d or calculated at schelduled intervals by use of Sw，皿 Ganz Catheters. Results Concentration of plasma inflammatory cytokine obviously decreased after HVHF , while mean arterial pressure (MAP) , indices of systemic vascular resistance (SVRI) , central venous press山e(CV町， cardiac index ( CI) hωno significant changes after the HVHF. Conclusio皿 HVHF can decrl四se concentration of plasma inflammatory cytokine in the p由ents wi由 severe trauma and has no significant effects on hemodynamics. [Key wo.nIs]阻gh volun把 hemofiltration (HVHF); Trauma ~ Inflammatory reaction; Hemo - dynamics 严重创伤后以全身性炎