间歇性高容量血液滤过对老年脓毒症合并多器官功能障碍综合征患者的疗效观察  

Efficacy of pulse high-volume hemofiltration in the treatment of elderly patients with multiple organ dysfunction syndrom

作　　者：黄阳[1,2] 邢昌赢[3] 储腊萍[2] 俞娅芬[2] 董文霞[2] 

机构地区：[1]南京医科大学,江苏南京210029 [2]江苏省无锡市第四人民医院肾内科,江苏无锡214062 [3]南京医科大学第一附属医院(江苏省人民医院)肾内科,江苏南京210029

出　　处：《中国医药导报》2011年第13期55-57,共3页China Medical Herald

摘　　要：目的:观察间歇性高容量血液滤过(PHVHF)治疗老年脓毒症合并多器官功能障碍综合征(MODS)的疗效。方法:16例脓毒症合并MODS的老年患者在接受传统治疗方法的同时行PHVHF治疗,观察治疗前后临床症状、生化指标、血浆炎症介质、急性生理学及慢性健康状况评价Ⅱ(APACHⅡ评分)、MODS评分的改变,以及对死亡率的影响。结果:PHVHF治疗后体温、心率、平均动脉压、急性炎症时相指标、血白细胞等指标均明显改善(P<0.01),血浆炎症介质TNF-α、IL-6、IL-8均明显下降(P<0.01),PHVHF治疗前后APACHⅡ评分分别为(18.94±2.32)分和(14.13±7.01)分(P<0.05),治疗前后MODS评分分别为(12.50±1.97)分和(9.63±3.91)分(P<0.05)。结论:PHVHF治疗MODS的老年患者,安全而有效,能降低死亡率。Objective： To observe the efficacy of pulse high-volume hemofiltration（PHVHF） in the treatment of elderly patients with sepsis complicated with multiple organ dysfunction syndrome（MODS）.Methods： 16 elderly patients with MODS received conventional therapy combined with PHVHF.During PHVHF,the patients′ conditions were observed and blood biochemistry,the levels of serum inflammatory mediator such as TNF-α,IL-6 and IL-8,acute physiology and chronic health evaluation Ⅱ（APACH II） scores and MODS scores were detected as well.We also observed the efficacy of the therapy on mortality.Results： After PHVHF,the clinical symptoms such as fever,tachycardia and mean arterial pressure were remitted（P0.01）.The levels of white blood cell（WBC）,TNF-a,IL-6 and IL-10 were decreased（P0.01）.The APACH Ⅱ scores were（18.94±2.32） and（14.13±7.01）（P0.05）,the MODS scores were（12.50±1.97） and（9.63±3.91）（P0.05）.13 of 16 patients survived,the mortality rate was 18.8%.Conclusion： The result of PHVHF in the treatment of elderly patients with sepsis complicated with MODS is safe and effective.

关 键 词：间歇性高容量血液滤过 多器官功能障碍综合征 老年人 

分 类 号：R459.7[医药卫生—急诊医学]