连续性静脉透析滤过治疗在急性肾损伤伴多器官功能障碍中的临床研究

Clinical study of successional vein dialysis on acute renal injury with multiple organ dysfunction syndrome

目的探讨急性肾损伤(AKI)伴多器官功能障碍综合征(MODS)患者的生存率、相关危险因素及预后,并与间断性血液透析(IHD)对比,为有效早期预防和治疗该病提供实用有效的治疗方法。方法对45例AKI伴MODS经连续性静脉-静脉血液透析滤过(CVVHDF)治疗患者的年龄、治疗前APACHEII评分,需要机械通气和治疗前后肾功能进行分析。结果 AKI伴MODS病人经CVVHDF治疗病死率为24.4%,年龄越小、治疗前APACHEII评分越低、需要机械通气比例越低及连续性血液净化(CBP)介入时间越早的病人存活率较高。治疗前尿素氮、血清肌酐越低,存活率越高。结论 AKI伴MODS临床表现重,病死率很高,尤其重症感染、休克、心衰、应用呼吸机及手术患者,单用药物治疗及间断血液透析难以奏效,强调早期介入以CVVHDF治疗为主的综合性治疗是救治成功的关键,更安全有效,提高危重症的救治成功率。

Objective To study the successional vein dialysis on acute renal injury with multiple organ dysfunction syndrome.Methods The APACHEII score and renal function of 45 patients with renal injury with multiple organ dysfunction syndrome treated with successional vein dialysis were analyzed.Results The fatality rate was 24.4%,which was related to the age,APACHEII score,urea nitrogen and serum creatinine.Conclusion Renal injury with multiple organ dysfunction syndrome has high fatality rate,whose key of treatment is complex therapy with early successional vein dialysis.