摘要
目的 :观察采用中西医结合方法治疗肝移植术后多器官功能障碍综合征 (MODS)疗效 ,探讨中西医结合治疗危重病的优势。方法 :5 4例肝移植术后并发 MODS患者 ,随机给予西医常规治疗及中西医结合治疗并根据预后分为存活组和死亡组 ,记录急性生理和慢性健康状况评分 (APACHE ) ,对病死率进行分析。结果 :5 4例患者 APACHE 均值显著高于总体均值 (P<0 .0 1)。存活组中药“血必净”用量、感染清除率、弥散性血管内凝血 (DIC)改善率、连续性静静脉血液滤过 (CVVHF)应用时间均明显高于死亡组 (P均 <0 .0 5 ) ;而呼吸机使用时限低于死亡组 (P<0 .0 5 ) ;中心静脉压 (CVP)、肺动脉楔压 (PAWP)均无显著差异 (P均 >0 .0 5 )。结论 :中西医结合治疗肝移植术后 MODS可改善临床指标 ,明显降低其病死率。
Objective:To observe the curative effect of integrated traditional Chinese and western medicine in treatment of multiple organ dysfunction syndrome (MODS) after liver transplantation,and investigate the superiority of integrated traditional Chinese and western medicine in treatment of critical disease.Methods:Fiftyfour patients of MODS after liver transplantation were randomly received conventional and integrated traditional Chinese and western medicine treatment,and they were divided into survial and dead group according to the prognosis.The acute physiology and chronic health evaluationⅢ(APACHEⅢ) were recorded and the mortality were analyzed.Results:The APACHEⅢ of 54 patients were much higher than totality (P<0.01). In survival group,the dose of Chinese medicine Shennong No.33(神农33号),elimination rate of infection position,the improvement rate of disseminated intravascular coagulation(DIC) and the duration of continuous venousvenous hemofiltration (CVVHF) were much higher than those in dead group (all P<0.05),but the duration of mechanical ventilation is much lower than dead group (P<0.05).There was no difference in central venous pressure(CVP) and pulmonary arterial wedge pressure(PAWP,all P>0.05). Conclusions:The method of integrated traditional Chinese and western medicine in treatment of MODS after liver transplantation can improve the clinical parameters,markedly reduce the mortality.
出处
《中国中西医结合急救杂志》
CAS
2002年第5期263-266,共4页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
天津市科技成果 ( No.2 0 0 2 30 5 8)
关键词
肝移植
多器官功能障碍综合征
中西医结合治疗
临床研究
手术后
multiple organ dysfunction syndrome
liver transplantation
integrated traditional Chinese and western medicine therapy
