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[外科脓毒症综合治疗中的体外解毒]

[Extracorporeal detoxication in combined treatment of surgical sepsis].

作者信息

Reshetnikov E A, Chuvanov M V, Denisov A Iu, Shipilov G F

出版信息

Khirurgiia (Mosk). 2001(1):71-3.

Abstract

The methods of extracorporeal detoxication acquire special importance in combined treatment of sepsis. The sessions of plasmapheresis, hemodialysis and isolated ultrafiltration were performed in 61 of 83 patients with sepsis. Indications to these methods are determined, their efficacy is evaluated. It is established that administration of antibiotics and immunoglobulins after sessions of plasmapheresis and hemodialysis to achieves therapeutic drug concentration in blood. It is difficult to select the dose of antibiotics and immunodrugs in permanent round-the-clock ultrafiltration since the part of them are eliminated through the filters. Overall lethality was 20.4% (17 of 83 patients died), in the group of patients with severe polyorganic insufficiency and septic shock who needed extracorporeal detoxication--27%.

摘要

体外解毒方法在脓毒症的综合治疗中具有特殊的重要性。83例脓毒症患者中有61例接受了血浆置换、血液透析和单纯超滤治疗。确定了这些方法的适应证并评估了其疗效。已证实,在血浆置换和血液透析治疗后给予抗生素和免疫球蛋白可使血液中达到治疗药物浓度。在持续24小时的超滤过程中,很难选择抗生素和免疫药物的剂量,因为部分药物会通过滤器被清除。总死亡率为20.4%(83例患者中有17例死亡),在需要体外解毒的严重多器官功能不全和感染性休克患者组中为27%。

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