连续性血液净化抢救伴有急性肾功能衰竭的多器官功能衰竭

目的 观察连续性血液净化(CBP)对合并急性肾竭的多器官功能衰竭(MOF)者的疗效.方法 对47例伴有急性肾衰的MOF患者行CBP,采用日间连续性静脉-静脉血液滤过模式.每例平均治疗(3.1±0.5)d.均采用稀释法输入置换液,流速2000～4000 ml/h.监测CBP前后病人的生命征、症状、血清生化指标和MODS计分.结果 CBP治疗后病人肾功能改善,MODS计分、血清肌酐均明显降低(P<0.01或<0.05).47例患者抢救成功29例.结论 CBP治疗MOF安全有效,病人死亡率降低.

Effect of continuous blood purification for management of multiple organ failure with acute renal failure

OBJECTIVE: To evaluate the effect of continuous blood purification (CBP) for treatment of multiple organ failure (MOF) with acute renal failure (ARF). METHODS: Forty-seven patients with MOF underwent CBP for an average of 3.1-/+0.5 days averagely. Continuous veno-venous hemofiltration was performed at daytime, and the substitute fluids were infused with pre-dilution at the rate of 2000-4000 ml/h. The general conditions, clinical symptoms, and serum biochemical indexes of the patients were observed and MODS score was calculated. RESULTS: After CBP, the MODS score of the patients decreased significantly from 9.1-/+3.5 to 5.4-/+2.7 (P<0.01) and serum creatinine decreased from 451.3-/+134.5 to 223.7-/+100.2 micromol/L (P<0.05). Twenty-nine patients survived with the survival rate of 61.7%. CONCLUSION: CBP is effective for treatment of MOF and may help reduce the mortality rate of MOF complicated by ARF.