亚低温高容量血液滤过治疗严重颅脑损伤后多器官功能障碍

Study of Mild-hypothermia High-volume Hemofiltration for the Treatment of Multiple Organ Dysfunction after Severe Brain Injury

[目的]探讨亚低温高容量血液滤过（HVHF）治疗严重颅脑损伤后多器官功能障碍患者的预后及与肿瘤坏死因子（TNF-α）、白介素-1（IL-1）、白介素-10（IL-10）水平的变化.[方法]无肝素化HVHF治疗重度颅脑损伤MOD患者,监测14 d患者病死率及监测患者治疗前、治疗后24 h、48 h TNF-α、IL-1、IL-10变化.[结果]血液滤过治疗24 h及48 h的TNF-α、IL-1、IL-10水平明显低于血滤治疗前.治疗14 d后治疗组病死率明显低于对照组.[结论]亚低温HVHF治疗严重颅脑损伤后MOD患者,能够降低炎症介质、改善其预后.

[Objectivel To explore the prognosis of patients with multiple organ dysfunction patients after severe brain injury treated by mild-hypothermia high-volume hemofiltration and the changes of tumor necrosis factor-alpha（TNF-α）, interleukin-l（IL-1） and interleukin-10（IL-10）. [Methods] Severe brain injury patients with multiple organ failure were treated with non-heparinized hemofiltration. The mortality 14 days after treatment and the changes of TNF-a, IL-1 and IL-10 at 24 hours and 48 hours before and after treatment were monitored. [Results] The levels of TNF-a, IL-1 and IL-10 at 24 hours and 48 hours after hemofiltration were obviously lower than those before hemofiltration. The mortality 14 days after hemofiltration in treatment group was obviously lower than that in control group; [Conclusion] Mild-hypothermia high-volume hemofiltration for the treatment of the patients with multiple organ dysfunction after severe brain injury can reduce the inflammatory mediators to improve their prognosis;