连续血液净化治疗对MODS患者呼吸及循环功能障碍改善的时效性观察  

The time effectiveness of continuous blood purification in patients with multiple organ dysfunction syndrome to improve the respiratory and circulation dysfunction

作　　者：李泽民[1] 王雪花[1] 武海燕[1] 陈敏[1] 王海芳[1] 卜贵峰[1] 纪丽萍[1] 

机构地区：[1]河北北方学院附属第二医院ICU,河北省宣化075100

出　　处：《疑难病杂志》2011年第9期656-658,共3页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的探索连续性血液净化(CBP)治疗对多脏器功能障碍综合征(MODS)患者呼吸、循环功能障碍改善的时效性,明确其作用机制及临床意义。方法选取ICU中同时具备呼吸、循环功能障碍的MODS患者20例,在常规治疗基础上,给予呼吸机辅助呼吸,采用连续性静一静脉血液滤过(CVVH)治疗,对比分析治疗前(0h)及治疗后不同时间窗(3h、6h、12h、24h、48h、72h)呼吸、循环功能改变。结果多巴胺用量:CBP治疗后3h较0h增加(P<0.05),6h时无统计学意义(P>0.05),12h时明显减少,且各循环指标均显著改善,差异有统计学意义(P<0.05),24h多巴胺用量明显减少(P<0.01);呼吸功能改善在治疗后24～72h有统计学意义(P<0.05,P<0.01)。结论 CBP治疗MODS患者,对于循环功能和呼吸功能有不同的时效性。Objective To investigate the time effectiveness of continuous blood purification（CBP） on patients complicated with multiple organ dysfunction syndrome（MODS） in improving respiratory and circulation dysfunction,and to explore their mechanism and clinical significance.Methods 20 cases complicated with MODS with respiratory and circulation dysfunction in ICU were treated with ventilator-assisted breathing and continuous veno-venous hemofiltration（CVVH） besides the routine therapy,the changes of clinical data on respiratory and circulation function were compared before treatment and different time points（3h,6h,12h,24h,48h and 72h） after CVVH.Results The amount of dopamine：At 3h after CBP,the amount of dopamine increased（P0.05）;At 6h after CBP,it was not significant compared with 3h after CBP（P0.05）; At 12h after CBP,the amount of dopamine was significantly lower than before,and circulating targets was significantly improved than those before treatment（P0.05）,at 24 hours after CBP significantly reduced the amount of dopamine（P0.01）.Respiratory function improved in 24～72 hours after treatment（P0.05,P0.01）.Conclusion The treatment of MODS patients with CBP has different time effectiveness in improving respiratory and circulation function.

关 键 词：连续性血液净化 连续性静—静脉血液滤过 呼吸机辅助呼吸 时效性 多脏器功能障碍综合征 

分 类 号：R459.7[医药卫生—急诊医学]