连续血液净化治疗多器官功能障碍综合征35例

目的:评价连续血液净化应用于重症监护室患者多器官功能障碍综合征(MODS)的效果与预后。方法:对35例MODS患者实施连续血液净化治疗,治疗过程中动态监测血压、心率、血氧饱和度。治疗前及治疗后实施血气分析,检查肝肾功能与电解质。结果:治疗后钠离子、钾离子、肌酐和尿素氮均较治疗前明显降低,而高钙离子和HCO₃-含量均较治疗前显著升高(P<0.01)。全部患者经连续血液净化治疗后,生存21例,病死14例,生存患者年龄、器官衰竭数以及APACHEⅡ评分均明显低于病死患者(P<0.01)。结论:应用连续性血液净化能够有效纠正重症监护室MODS患者的酸碱及水电解质紊乱,患者的年龄、器官衰竭数以及APACHEⅡ评分均能够影响其预后。

Effect of continuous blood purification in the treatment of multiple organ dysfunction syndrome in 35 cases

Objective:To evaluate the effects and prognosis of the continuous blood purification in the treatment of multiple organ dysfunction syndrome( MODS) . Methods:Thirty-five patients with MODS were treated with the continuous blood purification. The blood pressure,heart rate and blood oxygen saturation in all patients were dynamically monitored in the course of treatment. The blood gas, liver and renal function and electrolyte were evaluated before and after treatment. Results:The differences of the levels of sodium potassium,creatinine,urea nitrogen and HCO3- between before and after treatment were statistically significant(P<0. 01). Twenty-one cases survived,13 cases died. The differences of age, number of organ failure and APACHE Ⅱ score between survival and death patients were statistically significant(P<0. 01). Conclusions:The continuous blood purification can effectively correct the acid-base and electrolyte disturbance of patients with MODS. The age,number of organ failure and APACHE Ⅱ score can affect the prognosis of the patients.