持续静-静脉血液滤过治疗重症热射病合并多脏器功能衰竭临床分析

Clinical analysis of continuous veno-venous hemofiltration on severe heat stroke with multiple organ failure

目的探讨持续静-静脉血液滤过(CVVH)对重症热射病合并多脏器功能衰竭(MOF)的治疗作用。方法回顾分析4例重症热射病合并MOF,及时应用CVVH并采取综合治疗措施,对重症热射病合并MOF行血液净化治疗进行总结。结果通过早期积极采取CVVH联合综合治疗措施,快速降低患者体温,防止因高热引起的恶性循环,纠正水、电解质紊乱,2例患者未遗留脏器功能障碍,治愈出院。另2例患者因严重MOF伴重症弥散性血管内凝血(DIC)死亡。结论 CVVH可用于重症热射病合并MOF治疗,其可早期快速降低机体体温和纠正电解质及酸碱紊乱,且对代谢产物和炎症因子的清除也有重要作用。

Objective To analyze the role of continuous veno-venous hemofiltration （CVVH） in treating severe heat stroke with multiple organ failure （MOF）. Methods Four patients who had severe heat stroke with MOF were treated with CVVH and other comprehensive measures. The effect of CVVH applied in severe heat stroke with MOF was evaluated. Results Treated with CVVH and other comprehensive measures, the temperature decreased, and the infernal circle caused by hyperpyrexia was prevented, and water-electrolyte imbalance was corrected. 2 patients were cured, while the other 2 patients died of severe MOF and difused intravascular coagulation （DIC）. Conclusion CVVH acts as effective treatment in severe heat stroke with MOF by rapidly decreasing the temperature and improving electrolyte or acid-base equilibrium disturbance. Besides, CVVH may be effective to remove inflammatory factors and metabolites.