血液净化技术在多器官功能障碍综合征中的器官支持作用  

Multiple Organ Support Therapy from Blood Purification for Pediatric Critical Multiple Organ Dysfunction Syndrome

作　　者：杨镒宇[1] 郑亦男[1] 曾萍[1] 陶建平[1] 洪婕[1] 张剑晖[1] 朱翠平[1] 吴艳兰[1] 曾其毅[1] 

机构地区：[1]广州市儿童医院PICU,510120

出　　处：《岭南急诊医学杂志》2006年第3期169-171,共3页Lingnan Journal of Emergency Medicine

基　　金：广东省(卫生厅)医学科学技术研究基金资助项目(A2001579);广州市科学技术局的科技攻关计划基金资助科技攻关重点项目(2003Z2-E0181);广东省中医药局科研课题(1050064);广州市中医药中西医结合科研课题立项(2005A026)

摘　　要：目的:探讨血液净化技术(BP)对小儿多器官功能障碍综合征(MODS)的多器官支持治疗作用。方法:比较本院PICU16例危重患儿实施BP治疗后各器官的功能。结果:体温、心率、呼吸频率、全血白细胞计数、ESR和CRP各项临床常用炎症指标在BP治疗后均显著下降(P<0.001);BP治疗前后肾功能指标(血肌酐、BUN、尿量)、心肌酶谱(ALT、CK、CK-MB、LDH)、肝功能指标(总胆红素、白蛋白)、血气分析指标(pH、PaO2、PaO2/FiO2)均明显好转(P<0.05);BP治疗前后机械通气参数(PIP、PEEP)无明显改变(P>0.05),但Vt上升,P<0.05。结论:血液净化技术对小儿MODS不但有肾代替作用,而且有呼吸、循环、肝、酸碱和电解质内环境的平衡等多器官支持、治疗作用。Objective： To investigate the multiple organ support therapy （MOST） from blood purification （BP） for pediatric critical multiple organ dysfunction syndrome（MODS）. Methods： The organ functions of sixteen pediatric severe patients were compared before and after they were treated with BP in PICU of children＇s hospital. Results： Before and after BP , there were decreased changes in inflammatory indexes, which were temperature, heart rate, respiratory rate, WBC, ESR and CRP, all P 〈 0.001. There were changes in renal function （SCr, BUN and urine output）, in myocardial enzymes＇ series（ALT, CK, CK-MB and LDH ）,P 〈 0.05. There were improvement happened in hepatic function（total b＇dirubin and serum albumin）,P 〈 0.001. There were improvement in blood gases（ pH value, PaOz and PaO2/FiO2）, all P 〉 0.05. There were improvement in mechanical parameters for ventilation（PIP,PEEP） with beth p value 〉 0.05 and Vt with P 〈 0.05. Conclusions： BP can contribute either renal replacement or MOST covering lung, circulation, fiver and acid-base balance to pediatric critical MODS.

关 键 词：血液净化技术 小儿危重症 多器官功能障碍综合征 器官支持 

分 类 号：R459.7[医药卫生—急诊医学]