单针血液透析在抢救多脏器功能衰竭中的应用

报告用单针血液透析抢救21例慢性肾功能衰竭并发急性左心衰竭和脑衰竭的昏迷患者。21例患者中男15例,女6例,年龄22～56岁。经降压,脱水和强心治疗无明显效果后,即行单针血液透析。血泵维持血流量开始为50ml/min,超滤500～1000ml液体,临床症状缓解后改为维持血流量100～200ml/min。常规给予肝素抗凝,每次透析4～6h。结果死亡7例,共原发病均为慢性肾小球肾炎性尿毒症;存活14例(有效率为66.6%),其原发病为慢性肾小球肾炎性尿毒症10例,恶性肾小动脉硬化性尿毒症4例。14例中透析1次便开始清醒、心衰和脑衰症状基本消失者6例;透析2～5次后清醒,同时心衰和脑衰症状完全消失者8例。4例恶性肾小动脉硬化者已脱离透析出院2年,情况良好。

Single needle hemodialysis in the emergency treatment of multiple system organ failure

The mortality rate of the patients with multiplesystem organ failure(MSOF)was extremely high(particularly in the patient eith a failure of more than 3organs).We used the single needle hemodialysis in theemergency treatment of renal,cardiac and cerebralfailure(mainly renal)with satisfactory results in 21 pa-tients.15 were male with the age ranging from 20 to 56(average 33)and 6 females with the age ranging from22 to 35(average 28).7 patients died of uremia due tochronic glomerulo-nephritis.14 survived with an ef-fective rate of 66.6%.Among the 14 survivals,10 haduremia due to chronic glomerulo-nephritis and 4 haduremia due to malignant arteriosclerosis.