连续性血液净化在多器官功能障碍综合征中的应用

目的探讨连续性血液净化（CBP）用于多器官功能障碍综合征（MODS）患者的效果。方法 MODS患者39例,予高容量连续性静脉-静脉血液滤过（HV-CVVH）模式治疗。于CBP前、CBP开始后4 h、12 h、24 h、48 h、72 h测定心率（HR）、平均动脉压（MAP）、中心静脉压（CVP）、心排血量指数（CI）、氧合指数（PaO2/FiO2）、血BUN、Scr、G lu、Na＋、K＋及乳酸水平;比较治疗前、治疗后24 h、48 h、72 h急性生理功能和慢性健康状况（APACHEⅡ）评分。结果与CBP前比较,血Na＋、G1u水平差异无统计学意义（P〉0.05）;PaO2/FiO2、CI在CBP开始后4 h明显升高（P〈0.05）;BUN、Scr、HR及血乳酸和K＋明显降低（P〈0.05）。CBP治疗24 h、48 h、72 h后APACHEⅡ评分明显下降（P〈0.05）。结论 CBP能改善MODS患者的氧合功能,维持内环境稳定,在MODS患者的抢救中有一定的疗效。

Applications of continuous blood purification in the treatment of patients with multiple organ dysfunction syndromes

Objective To investigate the effects of continuous blood purification（CBP）in the treatment of patients with multiple organ dysfunction syndromes（MODS）.Methods 39 patients with MODS received High volume continuous venous-venous hemofiltration（HV-CVVH） therapy.HR,MAP,CVP,CI,PaO2/FiO2,BUN,Scr,Glu,Na＋、K＋and lactic acid were measured and recorded before CBP and 4h、12h、24h、48h and 72h after CBP.APACHEⅡ score were recorded before and 24 h、48 h and 72 h after CBP.Results There was no significant changes in blood Na＋ and Glu concentrations during and after CBP compared with the baseline values before CBP（P0.05）.PaO2/FiO2 and CI were significantly increased（P0.05）,while Blood BUN、Scr、HR、lactic acid and serum K＋ concentration were significantly decreased after 4 hours of CBP therapy（P0.05）.APACHEⅡ score were significantly decreased after 24h,48h and 72h of CBP therapy（P0.05）.Conclusion CBP can improve MODS patients′ oxygenation function and biochemical indicators,showing definite effects in the emergency treatment of MODS patients.