摘要
目的评估连续性血液滤过对多器官功能障碍综合征患者的治疗效果。方法对阳江市人民医院ICU2005年8月—2009年12月45例多器官功能障碍综合征患者分为CVVH治疗组及常规治疗组进行临床分析,对各组生存率及治疗前后患者的生命体征变化及治疗前后血肌酐、尿素氮、胆红素、C反应蛋白、TNF-α、IL-6含量变化进行统计分析,并计算各组治疗前后APACHEⅡ评分。结果 CVVH组与常规治疗组相比治疗生存率没有显著差别(P>0.05);CVVH组及常规治疗组在治疗后心率、MAP、氧合指数等一般情况及血肌酐、尿素值较治疗前均有明显改善(P<0.01),两组治疗后相比CVVH组血压、氧合指数、肌酐值优于常规治疗组(P<0.01),但心率、胆红素无明显区别(P>0.05);两组治疗后C反应蛋白、TNF-α、IL-6均较治疗前降低(P<0.01),但CVVH组下降程度较常规治疗组明显(P<0.01);两组治疗后APACHEⅡ评分均较治疗前显著降低(P<0.01),治疗前CVVH组APACHEⅡ显著高于常规治疗组(P<0.01),但治疗后两组间APACHEⅡ评分无显著差别(P>0.05)。结论在对多器官功能障碍的救治上连续性血液滤过可发挥一定作用,能有效清除相关炎症介质,延缓MODS的进一步发展,保护脏器功能。
Objective To investigate the effect of continuous veno-venous hemofiltration on patients with the multiple organ dysfunction syndrome（MODS）. Methods The patients were divided into 2 groups：Group A,26 patients with multiple organ dysfunction syndrome（MODS）were treated by CVVH.Group B（19 patients） were treated with conventional therapy except for CVVH.HR,MAP,PH,HCO3-,Oxygenation index,BUN,Scr,TBIL,and CRP,TNF-α,IL-6,electrolyte such as Na＋、K＋、Ca2＋、Cl-were measured before and after the treatment.And appraisal APACHEⅡbefore and after the treatment,then calculate survival rate. Results Atfer the treatment,all patients’general state of health such as HR,MAP,Oxygenation index and water-electrolyte and acid base disorder were improved（P〈0.01）.And the levels of BUN,Scr,CRP,TNF-α,IL-6 were improved than before（P〈0.01）.The APACHEⅡfract is significant decrease after treatment（P〈0.01）.There was significant difference on the levels of HR,MAP,BUN,Scr,CRP,TNF-α,IL-6 and between Group A and Group B after treatment（P〈0.01）,which indicated the therapeutic effect in Gorup A was better than that in Group B,but APACHEⅡfract and survival rate of Group A and Group B is indiscrimination. Conclusions CVVH has better curative effect on MODS.It can decrease the level of mediators of inflammation and prove the organ damage of the patients who had MODS.
出处
《医药论坛杂志》
2011年第2期16-19,共4页
Journal of Medical Forum
关键词
多器官功能障碍综合征
连续性血液滤过
全身炎症反应综合征
治疗
Multiple organ dysfunction syndrome
Continuous renal veno- venous hemofiltration
Systemic inlfammatory responses syndrome
Treatment
