多器官功能障碍综合征患者行连续性静脉-静脉血液滤过的临床研究

Clinical research in continuous veno-venous hemofiltration of patients with multiple organ dysfunction syndrome

目的探讨连续性静脉-静脉血液滤过（CVVH）对多器官功能障碍综合征（MODS）患者的治疗作用及临床监护要点。方法对22例MODS患者经中心静脉插管留置单针双腔导管，使用BRAUN Diapact CRRT机行CVVH方式治疗。于治疗前后30min抽取静脉血，检测尿素氮（BUN）、血清肌酐（Scr）及血清K^＋的浓度，采用ELISA法测定血浆肿瘤坏死因子α（TNF-α）、自细胞介素1（IL-1）、白细胞介素8（IL-8），同时抽取动脉血进行血气分析。并对治疗过程中生命体征进行监测。结果所有患者的CVVH治疗过程中生命休征稳定。CVVH后血清BUN、Scr、K^＋均逐渐下降，与治疗前比较差异显著，血浆TNF-α、IL-1、IL-8水平均逐渐降低，与治疗前比较差异显著。结论CVVH能改善血液生化指标，能清除血浆中多种细胞因子，且治疗过程中生命体征稳定，适用于MODS的治疗。

Objective To investigate the effect and monitoring point of continuous veno-venous hemofiltration （CVVH） in patients with multiple organ dysfunction syndrome （MODS）. Methods In 22 patients with MODS, a double lumen catheter was put into the central vein, and the CVVH was performed with the BRAUN Diapact CRRT. The level of BUN, Ser, serum potassium and arterial blood gas were measured 30 minutes before and after CVVH. The plasma TNF-α,IL-1 ,IL-8 were measured by ELISA. Vital signs were monitorial during treatment process. Results The vital signs of all patients＂ was stable, the levels of BUN,Ser and serum potassium decreased significantly ＇after CVVH. The plasma concentrations of TNF-α, IL-1 and IL-8 gradually decreased. Conclusions CVVH can improve tile blood biochemical markers,remove inflammatory cytokines in plasma, stablize the vital signs during treatment ,which is suitable for patients with MODS.