高容量连续性血液净化在多器官功能障碍综合征患者治疗中的应用

目的 探讨高容量与常规容量连续性血液净化(CBP)治疗多器官功能障碍综合征(MODS)的疗效.方法 选择MODS患者38例,随机分为高容量CBP组(治疗组)18例、常规容量CBP组(对照组)20例,观察并比较两组治疗后24、48 h平均动脉压(MAP)、多巴胺剂量、PaO2/FiO2、APACHEⅡ评分、血乳酸、ICU住院时间、ICU病死率.结果 治疗后24、48 h,治疗组MAP、PaO2/FiO2升高,多巴胺剂量、APACHEⅡ评分、血乳酸减少,与对照组比较差异均有统计学意义(均P＜0.05)；与对照组比较,治疗组ICU住院时间缩短 (8.54±4.15)d与(11.82±5.76)d]、ICU病死率明显降低(22.5％与35.0％)(均P＜0.05).结论 高容量连续性血液净化较常规容量连续性血液净化治疗MODS可降低病死率.

Application of high volume continuous blood purification in the treatment of multiple organ dysfunction syndrome

Objective To compare the effect of high volume continuous blood purification（CBP） with rou- tine CBP on multiple organ dysfunction syndrome（MODS）. Methods 38 patients with MODS were randomly divided into high volume CBP group（ treatment group, 18 eases） and routine CBP group （control group,20 cases）. And they were respectively detected on mean arterial pressure（MAP） , dosage of Dopamine, PaOJFiO2, APACHE II score,lactic acid,length of stay and mortality in ICU post-treatment 24h and 48h. Results Compared with control group,MAP and PaOJFiO2 on treatment group were more higher （ P 〈 O. 05 ） , while dosage of Dopamine, APACHE U score, lactic acid were significantly shorter than these of treatment group （ P 〈 O. 05 ）, and length of stay and mortality in ICU were signifi- cantly lower than those of treatmen group E （ 8.54 _＋ 4.15 ） d vs （ 11.82 _＋ 5.76 ） d, P 〈 0.05 ;22.2% vs 35.0%, P 〈 0.05 ]. Conclusion High volume CBP could reduce the mortality in ICU compared with control group routine CBP.