持续动静脉血滤(CAVH)在抢救危重病人高血容量血症中的应用

Application of continuous arteriovenous hemofiltration in the emergency treatment of hypervolemia in critically ill patients

本文报告应用 CAVH 抢救各种原因的急性高血容量危急状态患者29例(45例次)的治疗经验:1.CAVH 除水能力极强,除个别血压、心功能极差的终末期患者外,均能在短时间内缓解高血容量症征,显效率达86%。2.CAVH 可排除中、小分子量毒物,故亦可做为抢救药物中毒的手段。3.CAVH 做为治疗慢性尿毒症中分子物质蓄积的地位,已逐渐为 CAVHD 所取代。4.进行 CAVH治疗时,应特别注意体液平衡及保温,防止出现低体温、低血压及血液粘带度增高。

The experience of emergency treatment of acute hy- pervolemia due to different causes in 29 critically ill pa- tients(45 occasions)by continuous arteriovenous hemofiltration(CAVH)was reported:1)CAVH was found to be effective in relieving the symptoms of hyper- volemia in a short period of time by vigorously removing excess fluid,with a significant effective rate of 86%. However,there was an exception in the individual termi- nal stage patients with poor blood,pressure and cardiac function;2)CAVH could remove toxic substances of mid- dle and small molecules,hence it might be used in the emergency treatment of drug intoxication;3)as a means of treating chronic uremia with an accumulation of mid- dle molecular substances,CAVH has been gradually re- plced by CAVHD;4)special attention should be paid to body fluid balance and body temperature lest hypothermi- a,hypotension and elevated blood viscosity occur.