Dissertation > Excellent graduate degree dissertation topics show

Effect of Continuous Blood Purification on Prognosis and Endothelial Cell Function in Patients with Severe Sepsis

Author: SunZuo
Tutor: WangXiaoZhi；LvChangJun
School: Binzhou Medical College,
Course: Department of Respiratory Medicine
Keywords: Continuous blood purification Severe sepsis Endothelial cell function Activated protein C Min-1 soluble intercellular adhesion Von Willebrand factor
CLC: R459.7
Type: Master's thesis
Year: 2010
Downloads: 36
Quote: 0
Read: Download Dissertation

Abstract

To observe the continuous blood purification (CBP) on the treatment of patients with severe sepsis explore CBP endothelial cell function in patients with severe sepsis. [Methods] 45 cases of severe sepsis patients were randomly divided into a control group of 22 patients, CBP group of 23 patients. The control group conventional treatment in accordance with the the 2008 sepsis global treatment guidelines, CBP group in addition to the conventional treatment of sepsis Guide be treated with CBP, as of CVVH replacement fluid volume 40ml/Kg/h, treatment of 72 hours. Respectively before treatment (0h), treatment of 24h and 72h (CBP treatment termination 10min) detected in patients with arterial blood gas analysis, lactate, liver and kidney function, blood, and specimens from 2ml blood in a test tube containing sodium citrate, centrifuged specimens from plasma was stored at -80 ℃ stand. Using ELISA, plasma-activated protein C (APC), soluble intercellular adhesion molecule -1 (sICAM-1) and von Willebrand factor (vWF) content. Record vital signs such as blood pressure, heart rate, and APACHE II score were evaluated in patients before and after treatment changes underwent CVVH before and after treatment, while observing the ICU stay, ventilator the belt machine time, 28-day mortality. 【Results】 1, CBP patients ICU stay and mechanical ventilation time (P = 0.033; P = 0.039) shorter than the control group; 28-day mortality rate lower than the control group (P = 0.046). Treatment after 72h the CBP group of APACHE II score decreased degree of than the control group (P = 0.028). 3, in the treatment of 72h, CBP group MAP compared with the group before treatment increased (P = 0.007), the CBP group infected shock patients norepinephrine dosage was significantly lower than the control group (P = 0.036). 4, 72h after treatment, CBP lactate value lower than that of the control group (P = 0.001), oxygenation index increased (P = 0.001) compared with the group before treatment. 5, the control group, blood urea nitrogen (BUN), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were no significant changes before and after treatment the CBP group BUN, ALT and AST decreased 72h after treatment than before treatment (P = 0.033; P = 0.039; P = 0.009). 6, the control group activated protein C (APC), soluble intercellular adhesion min -1 (sICAM-1) and von Willebrand factor (vWF) had no significant changes before and after treatment. The CBP group APC appear higher (P = 0.007) in the treatment of 72h vWF and sICAM-1 in the treatment of 72h than before treatment decreased (P = 0.029; P = 0.012). 7, no significant change before and after the treatment of all deaths in patients with APC, sICAM-1 and vWF. Survivors sICAM-1 and vWF levels were lower than after treatment 72h death patients (P = 0.019; P = 0.025); survival in patients with APC concentration increased (P = 0.006) compared with the group before treatment. [Conclusion] CBP treatment can reduce the severity of sepsis condition to improve the prognosis of patients with severe sepsis; CBP can improve the patient's hemodynamic and oxygenation, and play a role in organ support; 3 CBP treatment can improve impaired endothelial function.

Effect of Continuous Blood Purification on Prognosis and Endothelial Cell Function in Patients with Severe Sepsis

Abstract

Related Dissertations