连续血液净化在儿童严重脓毒症中的应用

被引：36

作者：

张晨美 ^{[1
]}

朱益飞 ^{[2
]}

机构：

[1] 杭州, 浙江大学医学院附属儿童医院PICU

[2] 浙江省江山市人民医院儿科(浙江大学医学院儿科学研究生)

来源：

中华实用儿科临床杂志 | 2015年 / 30卷 / 06期

关键词：

严重脓毒症; 连续血液净化; 儿童;

D O I：

暂无

中图分类号：

R720.597 [儿科急症及处理];

学科分类号：

100202 [儿科学];

摘要：

脓毒症的发病机制复杂, 目前严重脓毒症的治疗仍是一大难题。感染性因素侵袭机体后, 引起其过度释放细胞因子和炎性介质, 导致炎性反应失控和免疫功能紊乱, 进而发展成为脓毒症及严重脓毒症。连续血液净化技术具有强大的溶质清除功能, 能清除体内过多水分、代谢废物、毒物及各种细胞因子、炎性介质。目前, 该技术不单纯应用于肾脏疾病, 而是被广泛应用于各种急危重症的抢救治疗。近年来, 不同脓毒症相关的治疗指南中均提出连续血液净化是治疗严重脓毒症的重要手段之一。早期应用连续血液净化治疗儿童严重脓毒症, 可明显改善患儿的心肺功能、肾功能、免疫功能及凝血功能等。该技术在儿童严重脓毒症中的应用将会越来越重要, 但仍存在一些问题有待进一步研究, 确定对脓毒症患儿进行个体化治疗将是今后研究的重点。

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