连续性血液净化治疗多器官功能障碍综合征的临床评价

Clinical Analysis of Patients with Multiple Organ Dysfunction Syndrome Treated by Continuous Blood Purification

目的观察连续性血液净化治疗(continuous blood purification,CBP)对多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)患者的治疗效果。方法采用连续性静脉-静脉血液滤过(continuous veno-venous hemofiltration,CVVH)模式治疗MODS患者17例,观察患者治疗前后APACHEⅡ、BP、HR、Scr、BUN、K+、pH和BE,以及死亡人数等指标的变化。结果接受CBP治疗后,17例MODS患者14例好转,有效率82.35%,死亡3例,病死率17.65%,17例患者30 d病死率为35.29%。APACHEⅡ评分明显低于治疗前(P<0.05);SBP、DBP较治疗前升高(P<0.05);HR较治疗前下降(P<0.05);Scr、BUN、K+、pH、BE、OI较治疗前明显改善(P<0.05)。结论 CBP可减轻患者病情,改善MODS患者血液生化指标,维持内环境稳定,改善患者的预后。

Objective To observe the therapeutic efficacy of continuous blood purification in the treatment of the patients with multiple organ dysfunction syndrome（MODS）. Methods Total 17 patients with MODS were treated by continuous veno-venous hemofiltration. The indexes of APACHE H , BP, HR, Scr, BUN, pH, BE and mortality rate were observed before and after the treatment. Results In 17 patients with MODS treated by CBP, 14 cases were improved, 3 cases died, the effective rate was 82.35% ,the mortality rate was 17.65% ,the 30-day mortality rate of them was 35.29%. Compared with the data before the treatment, APACHE Ⅱ score was significantly lower（ P 〈 0.05 ）, indexes of SBP and DBP were obviously increased（ P 〈 0.05 ）, index of HR was decreased （ P 〈 0. 05 ） , and indexes of Ser, BUN, K ＋ , pH, BE, OI were significantly improved （ P 〈 0. 05 ）. Conclusion By CBP,the condition of patients can be relieved, the blood biochemical indicators of patients can be improved, the homeostasis of patients can be maintained, and the prognosis of patients should be improved.