连续性静脉-静脉血液滤过串联血液灌流治疗多器官功能障碍综合征

Clinical efficacy of continuous venous-venous hemofiltration combined with hemoperfusion for patients with multiple organ dysfunction syndrome

目的:探讨连续性静脉-静脉血液滤过(continuous venous-venous hemofiltration,CVVH)串联血液灌流治疗多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者的临床疗效。方法:对2009年1月～2010年12月收治于我院的37例MODS患者行CVVH联合血液灌流治疗,观察治疗效果。结果:经过治疗,患者的体温、呼吸频率、心率等分别为(36.9±0.4)℃、(25.1±4.6)次/min、(95.6±14.2)次/min,均有显著性降低(P<0.05);平均动脉压为(85.7±7.5)mm Hg,显著升高(P<0.05);Na+、K+、BUN、Scr、IL-8、TNF-α等生化指标分别为(132.2±8.8)mmol/L、(4.06±0.68)mmol/L、(19.1±5.2)mmol/L、(386.4±132.7)μmol/L、(31.9±7.3)ng/L、(46.4±6.8)ng/L,均有显著性降低(P<0.05)。结论:CVVH联合血液灌流治疗MODS患者,能有效缓解患者的临床症状,改善患者的器官功能,且无明显不良反应,是一种较为理想的治疗方法。

Objective：To evaluate the effect of continuous venous-venous hemofiltration combined with hemoperfusion for patients with multiple organ dysfunction syndrome.Methods：37 cases with multiple organ dysfunction syndrome in our hospital from January 2009 to December 2010 were treated by continuous venous-venous hemofiltration and hemoperfusion.Results：After treatment,BT,BR,HR,MAP,Na＋,K＋,BUN,Scr,IL-8,TNF-α of the patients were（36.9±0.4）℃,（25.1±4.6） time/min,（95.6±14.2） time/min,（85.7±7.5） mm Hg,（132.2±8.8） mmol/L,（4.06±0.68） mmol/L,（19.1±5.2） mmol/L,（386.4±132.7） μmol/L,（31.9±7.3） ng/L and（46.4±6.8） ng/L,respectively.And they were much better than those before treatment,there were significant differences（all P〈0.05）.Conclusion：Continuous venous-venous hemofiltration combined with hemoperfusion can relieve the clinical symptom,improve the organ function of patients with multiple organ dysfunction syndrome,and no obviously adverse effect happened.It’s an ideal method for MODS.