AIMS We report 15 cases of abdominal-surgical multiple organ failure(MOF)treated successfully by a new combined therapy four high doses in volume and one support“FHDOS”short period high doses in large volume anJsoda...AIMS We report 15 cases of abdominal-surgical multiple organ failure(MOF)treated successfully by a new combined therapy four high doses in volume and one support“FHDOS”short period high doses in large volume anJsodaminum;short period high doses in large volume dexamethasonum;high doses in large volume of dis- infectant antibiotics;high doses in large volume of abdominal cav- ity washing liquor and support of nutrition metabolism.The mortal- ity rate and cost of MOF were decreased.It is simple,practical and effective. METHODS The study group consisted of 15 patients(10 wom- en,5 men;average age,42.7)who were hospitalized in our hospital.All patients were given“FHDOS”:short period high in large volume Anisodaminum:intravenous injection 40 mg once; another 40rag may be added 30 minutes later according to condition.The total amount may reach 120-240 mg a day,or,in- travenous injection 40 mg every 15 minutes until condition being under control.Short period high doses in large volume Dexamethasonum:intravenous injection 100-200 mg once;this remedy may be continued for 1-3 days;the amount also may de- crease according to condition.High doses in large volume of dis- infectant Antibiotics:select and use antibiotics according to clini- cal condition,inference of Gram's stain;it is necessary to re- peatedly culture bacteria in many parts,and then,to make ad- justment according to culture result and drug-resistance,and to prevent carefully the dual infections from occurring.High doses in large volume of abdominal cavity washing liquor:generally adopt- ing physiological saline 6000o8000ml in washing abdominal cavity. “One support”means full support of nutrition metabolism. RESULTS All the patients in this group survive well after the rescue without any complication. CONCLUSIONS MOF should be prevented,if possible,by stopping or controlling the injury,removing as much necrotic tis- sue as possible,improving blood flow and oxygen consumption, supporting metabolism,and preventing infection or treating it ear- ly and adequately.“FHDOS”is a combined therapy and plays a key role in treating MOF.展开更多
目的对危重患者应用连续性静脉-静脉血液滤过（CVVH）治疗过程中低磷血症的防治进行初步分析与探讨。方法选择危重患者30例，按急性生理与慢性健康评分（APACHEⅡ评分）不同分为2组（〈15分13例为A组，≥15分17例为B组）。两组均行CVVH...目的对危重患者应用连续性静脉-静脉血液滤过（CVVH）治疗过程中低磷血症的防治进行初步分析与探讨。方法选择危重患者30例，按急性生理与慢性健康评分（APACHEⅡ评分）不同分为2组（〈15分13例为A组，≥15分17例为B组）。两组均行CVVH治疗，置换液速度A组2000ml／h、B组4000ml／h，持续时间8～12h／d；补充甘油磷酸钠A组10～20ml／d，B组为30～40ml／d；治疗前、24小时、48小时、72小时检测血清磷的浓度、进行APACHEⅡ评分，井作血磷与APACHⅡ评分的相关分析，计算磷清除率。结果B组磷清除率大于A组[（42．76±2．39）ml／min vs （23．84±3．05）ml／min，P〈0．05]；治疗前B组血磷浓度低于A组[（0．78±0．19）mmol／L vs（1．25±0．27）mmol／L，P〈0．05]；第24小时两组血磷浓度均开始下降．补磷后第48小时A组血磷浓度正常，B组为轻度低磷血症，经调整补磷剂量后，第72小时恢复正常；CVVH治疗后两组患者APACHEⅡ评分均有降低的趋势；血磷与APACHEⅡ评分的相关分析提示两者呈负相关。结论危重患者易发生低磷血症，且与病情危重程度相关，采用CVVH治疗更易加重低磷血症，补磷应做到个体化，且不必拘泥于常规剂量限制。同时通过密切监测血磷变化来调整。展开更多
文摘AIMS We report 15 cases of abdominal-surgical multiple organ failure(MOF)treated successfully by a new combined therapy four high doses in volume and one support“FHDOS”short period high doses in large volume anJsodaminum;short period high doses in large volume dexamethasonum;high doses in large volume of dis- infectant antibiotics;high doses in large volume of abdominal cav- ity washing liquor and support of nutrition metabolism.The mortal- ity rate and cost of MOF were decreased.It is simple,practical and effective. METHODS The study group consisted of 15 patients(10 wom- en,5 men;average age,42.7)who were hospitalized in our hospital.All patients were given“FHDOS”:short period high in large volume Anisodaminum:intravenous injection 40 mg once; another 40rag may be added 30 minutes later according to condition.The total amount may reach 120-240 mg a day,or,in- travenous injection 40 mg every 15 minutes until condition being under control.Short period high doses in large volume Dexamethasonum:intravenous injection 100-200 mg once;this remedy may be continued for 1-3 days;the amount also may de- crease according to condition.High doses in large volume of dis- infectant Antibiotics:select and use antibiotics according to clini- cal condition,inference of Gram's stain;it is necessary to re- peatedly culture bacteria in many parts,and then,to make ad- justment according to culture result and drug-resistance,and to prevent carefully the dual infections from occurring.High doses in large volume of abdominal cavity washing liquor:generally adopt- ing physiological saline 6000o8000ml in washing abdominal cavity. “One support”means full support of nutrition metabolism. RESULTS All the patients in this group survive well after the rescue without any complication. CONCLUSIONS MOF should be prevented,if possible,by stopping or controlling the injury,removing as much necrotic tis- sue as possible,improving blood flow and oxygen consumption, supporting metabolism,and preventing infection or treating it ear- ly and adequately.“FHDOS”is a combined therapy and plays a key role in treating MOF.
文摘目的对危重患者应用连续性静脉-静脉血液滤过（CVVH）治疗过程中低磷血症的防治进行初步分析与探讨。方法选择危重患者30例，按急性生理与慢性健康评分（APACHEⅡ评分）不同分为2组（〈15分13例为A组，≥15分17例为B组）。两组均行CVVH治疗，置换液速度A组2000ml／h、B组4000ml／h，持续时间8～12h／d；补充甘油磷酸钠A组10～20ml／d，B组为30～40ml／d；治疗前、24小时、48小时、72小时检测血清磷的浓度、进行APACHEⅡ评分，井作血磷与APACHⅡ评分的相关分析，计算磷清除率。结果B组磷清除率大于A组[（42．76±2．39）ml／min vs （23．84±3．05）ml／min，P〈0．05]；治疗前B组血磷浓度低于A组[（0．78±0．19）mmol／L vs（1．25±0．27）mmol／L，P〈0．05]；第24小时两组血磷浓度均开始下降．补磷后第48小时A组血磷浓度正常，B组为轻度低磷血症，经调整补磷剂量后，第72小时恢复正常；CVVH治疗后两组患者APACHEⅡ评分均有降低的趋势；血磷与APACHEⅡ评分的相关分析提示两者呈负相关。结论危重患者易发生低磷血症，且与病情危重程度相关，采用CVVH治疗更易加重低磷血症，补磷应做到个体化，且不必拘泥于常规剂量限制。同时通过密切监测血磷变化来调整。
