摘要
目的 观察短时连续性血液净化治疗对灾难后多发伤所致多器官功能障碍综合征（multipleorgan dysfunction syndrome,MODS）患者的临床疗效.方法 将58例符合灾难后多发伤及MODS诊断标准的患者随机分为两组,A 组30 例患者采用24h 连续性静脉-静脉血液滤过（continuous venovenoushemodiafiltration,CVVH）治疗,即每日单次治疗时间24h;B组28例患者采用短时CVVH治疗,即每日单次治疗时间8小时.维持生命体征平稳的同时,于治疗前及治疗后第1、3、5、10日分别测定肿瘤坏死因子a（TNF-a）、高敏C反应蛋白（H-CRP）、白细胞介素（IL-1）、白细胞介素（IL-6）、血尿素氮（BUN）、血清肌酐（SCr）水平.结果 在治疗后各时间点,患者BUN、SCr均呈下降趋势（P〈0.05或P〈0.01）,但A组患者下降的幅度大于B组（P〈0.05）.TNF-a、CRP、IL-1、IL-6均呈下降趋势（P〈0.05）,但两组间比较差异无统计学意义（P〉0.05）.结论 短时连续性静脉-静脉血液滤过方式在改善肾功能基础上,与24hCVVH同等程度降低炎性因子水平,可以提高血液净化设备的利用率,更适用于重大灾害后多发伤所致MODS的救治.
Objective To investigate the efficacy of short-time continuous venovenous hemodiafiltration （CVVH） in the treatment of multiple injuries and multiple organ dysfunction syndrome（MODS）. Methodology Fifty-eight patients with multiple injuries and MODS were randomly divided into 2 groups： the 24h CVVH group （n=38） and the 8h CVVH group（n=28）. Serum ereatinine（Scr）, BUN, TNF-α, IL-6, IL-1,H-CRP were compared between the 2 groups before and after the treatment for ld, 3d, 5d and 10d. Mortality rate was compared at the end of the study. Results After the treatment, the levels of TNF-α, IL-6, IL-1, H-CRP decreased（P〈0.05）, in both groups and without statistical differences between the 2 groups（P〉0.05）. The levels of BUN and Scr decreased after the treatment in both groups（P〈0.05 or P〈0.01）, as compared with those of before the treatment. However, these changes were more evident in 24h CVVH group than in 8h CVVH group（P〈0.05）. Conclusion Short-time CVVH can improve the utilization of blood purification equipment, but also for major disasters caused by multiple injuries after the treatment of MODS.
出处
《中国急救复苏与灾害医学杂志》
2012年第1期53-55,60,共4页
China Journal of Emergency Resuscitation and Disaster Medicine
基金
天津市自然科学基金资助课题面上项目（NO.09JCYBJC09900）
关键词
连续性静脉-静脉血液滤过
多发伤
多器官功能衰竭
Continuous continuous venovenous hemodiafihration
Multiple organ dysfunction syndrome
Multiple injuries
