序贯性血液净化治疗MODS患者对改善脏器功能、降低APACHE Ⅱ评分的作用

Effect of sequential blood purification on improving organ function and reducing APACHE Ⅱ score in patients with MODS

目的:探讨序贯性血液净化治疗多器官功能障碍综合征(MODS)的临床效果。方法:选取2020年2月~2021年1月在我院治疗的MODS患者66例,根据治疗方案分为观察组(n=32)和对照组(n=34),观察组给予序贯性血液净化治疗,对照组给予单种血液净化治疗,观察两组治疗前后肝肾功能、血流动力学、APACHEⅡ评分及病死率。结果:观察组治疗后3d时丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、血肌酐(Scr)和尿素氮(BUN)明显低于对照组;观察组治疗后3d时心率(HR)明显低于对照组,而平均动脉压(MAP)、心脏指数(CI)和氧合指数(PaO;/FiO;)明显高于对照组;观察组治疗后3d时APACHEⅡ评分明显低于对照组;两组患者病死率比较差异无统计学意义。结论:序贯性血液净化治疗MODS有较好的效果,改善患者肝肾等脏器功能,降低APACHEⅡ评分。

Objective To investigate the clinical effect of sequential blood purification in the treatment of multiple organ dysfunction syndrome(MODS).Methods 66 patients with MODS treated in our hospital from February 2020 to January 2021 were selected and divided into observation group(n=32)and control group(n=34)according to the treatment plan,the observation group was given sequential blood purification treatment,and the control group was given single blood purification treatment,the liver and kidney function,hemodynamics,APACHE II score and mortality of the two groups before and after treatment were observed.Results The alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(Scr)and urea nitrogen(BUN)in observation group after treatment 3 d was significantly lower than the control group;The heart rate(HR)of the observation group at 3 days after treatment was significantly lower than that of the control group,while the mean arterial pressure(MAP),cardiac index(CI)and oxygenation index(PaO;/FiO;)were significantly higher than those of the control group;The APACHEⅡscore of the observation group at 3 days after treatment was significantly lower than that of the control group;There was no significant difference in the mortality between the observation group and the control group.Conclusion Sequential blood purification has a good effect in the treatment of MODS,which can improve the liver and kidney function and reduce APACHEⅡscore.