连续性血液透析滤过在多器官功能障碍综合征犬中的器官支持作用

目的:探讨连续性血液透析滤过(CVVHDF)对多器官功能障碍综合征(MODS)犬的多器官支持治疗作用。方法:15只雄性Beagle犬,采用失血性休克 复苏灌注 内毒素血症复制MODS模型,随机分为CVVH-DF组(n=8)和MODS组(n=7),CVVHDF组在内毒素注射完毕后给予CVVHDF治疗12 h,MODS组不给予CVVHDF治疗。观察两组动物体温、血压、心率、全血白细胞计数和各器官的功能指标变化。结果:体温、血压、心率、全血白细胞计数指标在CVVHDF治疗后均明显好转;CVVHDF组治疗过程中,平均动脉压(MAP)基本保持在正常水平,尤其在T5、T6及T7时间点显著高于MODS组(P<0.01);PaO2逐渐升高,与MODS组在T4、T5、T6及T7时间点相比差异有统计学意义(P<0.05);血清肌酐(Cr)、血尿素氮(BUN)水平与MODS组在T4、T5、T6及T7时间点相比显著降低(P<0.05);结论:CVVHDF对MODS不但有肾代替作用,而且有呼吸、循环、酸碱和电解质内环境的平衡等多器官支持、治疗作用。

Multiple organ support therapy from continuous veno-venous haemodiafiltration in a canine model for multiple organ dysfunction syndrome

Objective:To investigate the multiple organ support therapy(MOST) fromcontinuous veno-venous haemodiafiltration(CVVHDF) in a canine model for multiple organ dysfunction syndrome(MODS).Methods: Fifteen Beagle dogs were subjected to hemorrhagic shock plus resuscitation and endotoxemia to set up MODS model,then dogs were randomly divided into 2 groups: CVVHDF group(n=8) and MODS group without CVVHDF(n=7).CVVHDF was performed ahout 12 hours after endotoxin injection was finished in CVVHDF group.Temperature,blood pressure,heart rate,WBC and organ function parameters were observed in dogs.Results:The inflammatory indexes of dogs in CVVHDF group became better than those in MODS group.The beneficial effect of CVVHDF on the hypotensive effect of MODS model was particularly striking at T5,T6 and T7(P<0.01).Mean PaO2 in CVVHDF groups at T4,T5,T6 and T7 was significantly higher than those in MODS group(P<0.05).The levels of Cr,BUN at T4,T5,T6 and T7 were decreased significantly in the CVVHDF group compared with the MODS group(P<0.05).Conclusion:CVVHDF can contribute either renal replacement or MOST covering lung,circulation,liver and acid-base balance to MODS dogs.