内科

目的探讨连续性血液净化（CBP）用于多器官功能障碍综合征（MODS）患者的效果。方法MODS患者39例，予高容量连续性静脉-静脉血液滤过（HV-CVVH）模式治疗。于CBP前、CBP开始后4 h、12 h、24 h、48 h、72 h测定心率（HR）、平均动脉压（MAP）、中心静脉压（CVP）、心排血量指数（CI）、氧合指数（PaO2/FiO2）、血BUN、Scr、Glu、Na+、K+及乳酸水平；比较治疗前、治疗后24 h、48 h、72 h急性生理功能和慢性健康状况（APACHEⅡ）评分。结果与CBP前比较，血Na+、G1u水平差异无统计学意义（P＞0.05）；PaO2/FiO2、CI在CBP开始后4 h明显升高（P＜0.05）；BUN、Scr、HR及血乳酸和K+明显降低（P＜0.05）。CBP治疗24 h、48 h、72 h后APACHEⅡ评分明显下降（P＜0.05）。结论CBP能改善MODS患者的氧合功能，维持内环境稳定，在MODS患者的抢救中有一定的疗效。

ObjectiveTo investigate the effects of continuous blood purification(CBP)in the treatment of patients with multiple organ dysfunction syndromes(MODS).Methods39 patients with MODS received High volume continuous venous-venous hemofiltration (HV-CVVH) therapy.HR,MAP,CVP,CI,PaO2/FiO2,BUN,Scr,Glu,Na+、K+and lactic acid were measured and recorded before CBP and 4h、12h、24h、48h and 72h after CBP.APACHEⅡ score were recorded before and 24 h、48 h and 72 h after CBP.ResultsThere was no significant changes in blood Na+ and Glu concentrations during and after CBP compared with the baseline values before CBP(P＞0.05).PaO2/FiO2 and CI were significantly increased(P＜0.05),while Blood BUN、Scr、HR、lactic acid and serum K+ concentration were significantly decreased after 4 hours of CBP therapy(P＜0.05).APACHEⅡ score were significantly decreased after 24h, 48h and 72h of CBP therapy(P＜0.05).ConclusionCBP can improve MODS patients′ oxygenation function and biochemical indicators,showing definite effects in the emergency treatment of MODS patients.

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