连续性血液净化抢救多脏器功能衰竭30例分析

Analysis of Rescuing 30 Cases with Multiple Organ Failure by Continuous Blood Purification

目的 应用连续性血液净化（continuous blood purification,CBP）抢救多脏器功能衰竭（multiple organ failure,MOF）,提高存活率。方法 应用连续性动-静脉血液滤过（continuous arte-rio-venous hemofiltration,CAVH）,连续性静-静脉血液滤过（continuous veno-venous hemofiltration,CV-VH）,连续性动-静脉血液透析滤过（continuous arterio-venous hemodiafiltration,CAVHDF）,连续性静-静脉血液透析滤过（continuous veno-venous hemodiafiltration,CVVHDF）抢救急性肾衰伴多脏器功能衰竭30例分别行CBP维持16-168h。结果 有效19例,其中12例治愈出院,6例明显好转,1例行长期血液透析治疗。死亡11例其中2例放弃治疗,2例死于呼吸衰竭,3例死于严重感染,2例心脏骤停,2例死于手术并发症。结论 连续性血液净化过程中血流动力学稳定,连续性血液净化能有效纠正氮质血症和水电解质酸碱紊乱,明显提高多脏器功能衰竭患者的存活率,降低死亡率。

Objective To rescue the patients with multiple organ failure （MOF） by continuous blood purification and improve survival rate. Methods 30 patients with acute renal failure complicated with multiple organ dysfunction were rescued by continuous arterio-venous hemofihration （CAVH） ,continuous venous-venous hemofiltration （CVVH） ,continous arterio-venous hemodiafiltration （CAVHDF） and continous venous-venous hemodiafiltration （ CV- VHDF） ,and each of them were retained for 16 - 168 h by continuous blood purification （CBP）. Results 19 cases were available among the total, and 12 cases were cured and discharged, 6 cases improved obviously, 1 cases was treated by long-termed hemodialysis; 11 cases were dead, 2 cases of whom gave up the treatment, 2 cases died of respiratory failure, and 3 cases for severity infected, 2 cases died of cardiac arrest, and 2 cases for s operative compli- cation. Conclusion In the course of CBP, hemodynamicses were stable. And CBP could effectually correct azotemia and disorder of water-electrolyte balance so as to improve the survival rate of patients with MOF obviously, and lower the mortality.