连续肾替代疗法对小儿MODS治疗的临床分析

Clinical analysis of continuous renal replacement therapy in pediatric multiple organ dysfunction syndrome

目的 调查分析持续肾替代疗法 (CRRT)在儿科MODS中的治疗作用。 方法 回顾性总结 1998～ 2 0 0 1年我院PICU应用连续静静脉血液滤过和连续静静脉血液滤过透析 (CVVH/D)的临床资料。 结果 CVVH/D治疗 1个月～ 13岁的MODS患儿 12例 ,均存在 3个或 3个以上的脏器功能障碍。持续治疗时间 12～ 2 5 2h ,平均 ( 93 6± 83 9)h。 2例高血容量性肺水肿明显缓解 ,所有病例纠正了酸碱和水电解质紊乱。存活 5例 ,死亡 7例。 结论 CRRT具有清除体内过多液体和纠正酸碱、电解质紊乱的显著疗效 ,是一种PICU内可实行的安全而经济的治疗手段。

Objective To investigate the effect of continuous renal replacement therapy (CRRT) in pediatric multiple organ dysfunction syndrome (MODS) with renal failure.Methods The clinical condition and laboratory data of children with MODS were analysed before and after CRRT which includes CVVH/D.Results Twelve patients with MODS were treated with CVVH/D that was continously used for 12～252 h,average (93\^6±83\^9)h.Two patients with hypervolemic pulmonary edema were significantly improved, all cases were success in fluid balance.Five of 12 patients survived,and seven died.Conclusion CRRT is more effective in preventing fluid overload and in correcting acid-base/electrolyte unbalance in children with MODS. It is a safe,economic therapy in PICU.