不同稀释法连续性血滤对多器官功能不全综合征患者氧合功能的影响  

Changes of oxygenate function in patients with multiple organ dysfunction syndrome during continuous venovenous hemofiltration by different dilution modes

作　　者：罗辉遇[1] 谢长江[2] 古英明[3] 陈飞鹏[4] 

机构地区：[1]广州医学院第二附属医院老年病学科,510260 [2]广州医学院第二附属医院监护病房,510260 [3]广州医学院第二附属医院血液净化中心,510260 [4]广州医学院第二附属医院呼吸内科,510260

出　　处：《中华全科医师杂志》2011年第1期52-53,共2页Chinese Journal of General Practitioners

基　　金：广州市医药卫生科技项目（2007-YB-162）

摘　　要：对监护病房2003年6月至2008年6月以不同稀释法连续性静脉-静脉血滤（CVVH）的多器官功能不全综合征患者氧合指数的变化做回顾性分析,其中前稀释法13例,后稀释法15例.结果 显示,总病死率为46%（13/28）;在48 h内,全部患者平均氧合指数水平明显上升（P＜0.05）,前稀释法患者氧合指数水平明显升高（P＜0.05）;,后稀释法无明显变化（P＞0.05）.生存组氧合指数水平明显提高（P＜0.05）,死亡组变化不明显（P＞0.05）.提示CVVH能改善多器官功能综合征患者的氧合功能和预后,前稀释法可能是较有效的治疗模式。Twenty eight patients with multiple organ dysfunction syndrome （MODS） underwent continuous venovenous hemofiltration （CVVH）in ICU from June 2003 to June 2008, including 13 cases treated with predilution mode and 15 with postdilution mode. The changes of oxygenate index（ PaO2/FiO2 ）during CVVH were retrospectively analyzed. The total case fatality rate of this group of patients was 46%（13/28）. There was a significant increase in PaO2/FiO2 of 28 cases during the first 48 h of CVVH （P 〈0. 05）;the levels of PaO2/FiO2 in predilution group had increased significantly within 48 h during CVVH （P〈0. 05）, while those in postdilution group had not significantly changed （P 〉 0. 05）. There was a significant increase in Pa02/FiO2 for the survival patients during the first 48h CVVH（ P 〈 0. 05 ）, while no significantly change in the fatal cases（P 〉0. 05 ）. In summary, oxygenate function and outcome of patients with MODS can be improved by CVVH, and predilution may be a more effective mode.

关 键 词：多器官功能衰竭 血液滤过 

分 类 号：R459.7[医药卫生—急诊医学]