高容量血液滤过(HVHF)治疗MODS的临床效果探讨  

Clinical Effects Discussion of High-volume Hemofiltration Treating in Patients with Multiple Organ Dysfunctionsyndrome

作　　者：俞丽[1] 谭波[2] 邓宁[1] 唐小卿[1] 刘锡松[1] 

机构地区：[1]重庆市第九人民医院重症监护室,重庆400700 [2]重庆市第九人民医院急诊科,重庆400700

出　　处：《现代生物医学进展》2013年第18期3542-3545,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨高容量血液滤过(HVHF)治疗多器官功能障碍综合征(MODS)的临床效果及对患者炎症介质水平和血氧情况的影响。方法:所有患积极治疗原发病,并在此基础之上进行HVHF治疗。若患者首次治疗后病情有反复,则再次给予HVHF治疗。结果:本组40例患者当中,22例治愈,治愈率55%;12例临床死亡,均为HVHF停止治疗后因多脏器功能衰竭致死,病死率30%;6例主观放弃治疗,占15%。患者治疗后2 h、4 h和8 h的IL-6、IL-8和TNF-α指标逐渐下降,且治疗后8h指标与其它时间比较具有显著差异(P<0.05)。治疗前后SOFA评分具有显著差异(P<0.05)。结论:在HVHF治疗MODS的过程中,炎症介质的减少和血氧浓度的提高参与到患者病理变化的过程当中,HVHF的应用可有效抑制患者体内IL-6、IL-8和TNF-α等参与的炎性病变过程,同时,HVHF可增加患者机体内氧摄入量,减轻因缺氧造成的细胞组织病变,使病情和预后获得较好的改善。Objective：To discuss the levels of inflammatory mediators,oxygen and clinical effects of high-volume hemofiltration（HVHF） treating in patients with multiple organ dysfunctionsyndrome（MODS）,by selecting multiple organ dysfunction syndrome（MODS） patients in our hospital for clinical research.Methods：All patients were heparin saline pre-fillec rail pipelines and filter vitro anticoagulant positive primary disease before treatment,and operated HVHF on the basis.HVHF was given twice if patients had disease repeated in the first HVHF.Results：422 cases in 40 cases were cured with 55%,12 cases was dead with 30%,and gave up treatment subjectively with 15%.IL-6,IL-8 and TNF-αg radual decline after treatment 2 h,4 h and 8 h,and the 8 h index had significantly difference with other times（P0.05）.The SOFA score had significant difference before and after treatment（P0.05）.Conclusions：The process of reduction of inflammatory mediators and oxygen concentration in the HVHF treatment MODS process,to participate in the pathological changes in patients with the HVHF applications can effectively suppress the patient＇s body IL-6,IL-8 and TNF-α participation inflammation which disease process.Meanwhile,HVHF oxygen intake can increase the body of patients,reduce tissue lesions caused by lack of oxygen,and better improve the condition and prognosis.

关 键 词：高容量血液滤过 多器官功能障碍综合症 临床效果 

分 类 号：R459.5[医药卫生—治疗学]