早期连续性血液净化治疗多器官功能障碍综合征的临床疗效  

A clinical evaluation on early blood purification in the treatment of patients with multiple organ dysfunction syndrome

作　　者：杨丽敏[1] 陈兵[1] 刘健[1] 刘毅[1] 王洪霞[1] 李真玉[1] 

机构地区：[1]天津医科大学第二医院急救中心ICU,300211

出　　处：《中国急救医学》2011年第3期200-202,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的 探讨早期应用连续性血液净化技术（continuous blood purification, CBP）治疗多器官功能障碍综合征（multiple organ dysfunction syndrome, MODS）的临床疗效.方法 98例MODS患者,其中治疗组（MODS发生48 h内行CBP治疗）46例,对照组（MODS发生48 h后行CBP治疗）52例,分别行CBP治疗48～276 h.观察并比较两组CBP治疗24、48 h急性生理和慢性健康状况评分Ⅱ（APACHEⅡ）、MODS评分及ICU住院时间、ICU病死率.结果 两组年龄、性别及发生MODS时APACHEⅡ评分、MODS评分比较差异均无统计学意义（P〉0.05）;治疗24、48 h 两组APACHEⅡ评分、MODS评分比较差异均有统计学意义（P〈0.05）.两组ICU住院时间及病死率比较差异均有统计学意义（P〈0.05）.结论 尽可能早期开展CBP治疗,能提高MODS患者的救治成功率.Objective To investigate the treatment of early continuous blood purification （CBP） in the patients with multiple organ dysfunction syndrome （MODS）. Methods 98 patients with MODS were observed in this study and were divided into early treatment group and control group at random. 46 patients in early treatment group underwent early CBP in the first 24 hours of attack, the rest （52 patients ） in control group were treated with CBP within another 24 hours. The blood routine examination, hepatic and renal function, PT, FIB, APTT, blood sugar, electrolyte, and blood gas analysis were taken,scores of acute physiology and chronic health evaluation（APACHE Ⅱ ）, and MODS score were analysed respectively at 24,48 h during CBP. Results Compared with control group, the APACHE Ⅱ and MODS scores of early treatment group decreased significantly at 24 h and 48 h after CBP （P 〈 0. 05 ）. Compared with control group, the length of stay was shorter and the mortality rate was lower in early treatment group during ICU （ P 〈 0. 05 ）. Conclusion Early CBP is an effective therapy and improves the outcome of patients with MODS.

关 键 词：连续性血液净化 多器官功能障碍综合征 预后 

分 类 号：R59[医药卫生—内科学]