连续性肾脏替代治疗多器官功能障碍综合征的急救

Emergency of multiple organ dysfunction syndrome using continuous renal replacement therapy

目的探讨应用连续性肾脏替代治疗(CRRT)对多器官功能障碍综合征(MODS)合并重症急性肾衰竭(ARF)患者的临床疗效和影响预后的因素。方法回顾性分析36例MODS患者行CRRT的临床资料,根据存活时间是否超过15 d分为存活组和死亡组,分别对器官衰竭数目及类型、APACHEⅡ评分、从出现肾功能不全至开始行CRRT的时间、行CRRT总时间及临床指标进行比较。结果存活组与死亡组年龄、性别、原发病类型比较无统计学差异,而在器官衰竭数目及类型、APACHEⅡ评分、从出现肾功能不全至行CRRT时间、治疗总时间及并发症发生率方面,两组均有统计学差异。结论CRRT为MODS的急救手段之一,早期根据病情选择合适的治疗模式和剂量应用CRRT可提高MODS抢救成功率。

Objective To investigate the effects of continuous renal replacement therapy（CRRT）on multiple organs dysfunction syndrome（MODS）in patients combined with severe acute renal failure（ARF）. Methods The clinical data of 36 MODS patients in our hospital from 2002 to 2007 were analyzed retrospectively.According to the survival time,the patients were divided into two groups：survival group（survival time≥15 d） and death group（survival time≤15 d）.The numbers and categories of organ failure,APACHEⅡ,the time from emerging renal function insufficiency to performing CRRT,time of CRRT therapy,and clinical index were compared between 2 groups. Results There was no significant difference in age,gender and types of primary diseases between two groups.However,the numbers and categories of organ failure,APACHEⅡ,and the time for emerging renal function insufficiency to performing CRRT,treatment time and the complications were significantly different between 2 groups. Conclusion CRRT is one of emergency therapies for MODS.The suitable treatment mode and dosage according to pathogenetic condition in early stage could increase the survival rate.