连续性血液净化在多脏器衰竭中的应用评价  

The effects of continuous blood purification in severe cases with acute renal failure

作　　者：刘艳红[1] 王昱[1] 邓莹沛[1] 

机构地区：[1]漯河市中心医院血液净化中心,河南省漯河462000

出　　处：《中国基层医药》2006年第8期1286-1288,共3页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析连续性血液净化(CBP)在伴急性肾衰的多脏器衰竭患者中的疗效。方法2005年9月至2006年1月在该院重症监护室(ICU)住院的伴急性肾衰(ARF)的危重患者7例行连续性静脉-静脉血液滤过(CVVH),观察治疗中生命体征(心率、平均动脉压)的变化,检测血常规、血凝常规、血气分析、肾功能、电解质、肝功能、血糖和心肌酶,记录并发症和滤器寿命。结果(1)血流动力学稳定；(2)肾功能恢复4例；最终存活2例；(3)合并并发症5例(低温3例,出血2例,滤器凝血1例,其他1例)；(4)滤器寿命为12～108h,最长达108h；(5)APACHEⅡ评分CVVH前为10～35分,治疗后为13～28分。结论CBP在伴急性肾衰的危重患者中疗效肯定,乳酸盐方2L/h的置换速度无不耐受情况。Objective To analyze the effects of continuous blood purification in severe cases with acute renal failure. Methods 7 cases of severe cases with acute renal failure in intensive care unit（ICU） from September 2005 to January 2006 had received CVVH,the change of their life signs were observed during the whole session of treatment,blood samples were collected from the patients, biochemical parameters were tested before and after the treatment, the complication and the life of fihrater were recorded. Results （ 1 ） During CVVH, patients hemodynamic parameters such as heart rate（HR）,mean artery pressure（MAP） were steady; （2）5 cases in renal fuction recovered, 2 cases survived. （3）There was 4 cases merged complication（low temperature 3,bleeding 2, fihrater coagulated 1, else 1 ） ; （4） The life of fihrater was 12 - 108 hours, the longest is 108 hours; （5） The acute physiology and chronic health evaluation（APACHE Ⅱ ） scores were from 10- 35 before treatment to 13-28 after treatment. Conclusion The effects of continuous blood purification in severe cases with acute renal failure are affirmed ,and there is no unwell with the speed of 2L/h lactate-buffered fluids.

关 键 词：血液滤过 多脏器衰竭 APACHEⅡ评分 

分 类 号：R459.5[医药卫生—治疗学]