多脏器功能障碍综合征患者应用CRRT治疗的临床研究

Continuous renal replacement therapy for patients with multiple organ chysfunction syndrome

目的:观察连续性肾脏替代治疗(CRRT)对多器官功能障碍综合征的疗效。方法:选择由各种病因导致的多器官功能障碍综合征患者52例,全部给予CRRT治疗,并检测CRRT前后的肾功能、电解质及动脉血气,利用美国BioZ○R无创心脏动力学系统监测血流动力学改变。结果:治疗前患者肾功能BUN、Scr和血清钾、血糖高,CRRT治疗后BUN、Scr和血清钾明显降低,血糖趋于稳定,与治疗前相比,差异有统计学意义(P<0.05)。血清钠、血清钙趋于稳定。CRRT治疗过程中,患者pH值渐趋正常,与治疗前相比,差异有统计学意义(P<0.05)。治疗前PaO2/FiO2低,CRRT治疗后与治疗前比较差异有统计学意义(P<0.05)。治疗前后患者CI、SVR、TFC、CVP均有明显改善(P<0.05)。结论:应用CRRT治疗MODS患者可有效改善肾功能,调节酸碱失衡、电解质紊乱,有效改善急性呼吸衰竭,患者血流动力学趋于稳定,有利于改善患者的预后。

Objective To observe the therapeutic effects of continuous renal replacement therapy （CRRT） in multipal organ dysfunc- tion syndrom（MODS）. Method Total 52 patients with MODSwere involved by a variety of causes in our hospital. All the cases accepted the therapy of CRRT, and renal function, blood electrolyte, arterial blood gas analysis were from beginning to end of CRRT. Meanwhile the changes of hemodynamics was using american BioZ（B non - invasive cardiac dynamic system. Results Before treatment, the patients＇s renal function（BUNScr） and serum potassium, blood sugar were high, after CRRT treatment, BUN Scr and serum potassium significantly reduced, and blood sugar stabilized compared with pre - treatment, there was a significant difference （ P 〈 0. 05 ）. Serum sodium, serum calcium stabilized. During the course of CRRT, the PH became normal comparing with pre -treatment ,there was a significant difference （P 〈 0. 05 ）. PaO2/FiO2 was low before treatment, compared with pre - treatment after CRRT, there was significant differences （ P 〈 0.05）. The CI, SVR, TFC, CVP of the patients were significantly improved after treatment （ P 〈 0. 05 ）. Conclusion Application of CRRT in patients with MODS can be effective in improving renal function, regulating acid -base imbalance, electrolyte disorders, and improving acute respira- tory failure. Hemodynamics of the patients become more stable,is in favour of improving the prognosis of the patients.