评价连续性血液净化在ICU多器官功能障碍综合征合并急性肾衰竭患者的应用价值  

Evaluation of Application Value of Continuous Blood Purification ICU Value in Patients with Multiple Organ Dysfunction Syndrome Complicated with Acute Renal Failure

作　　者：孙卉力[1] SUN Hui-li(Critical Care Medicine Department,Laizhou People's hospital,Yantai,Shandong Province,261400 China)

机构地区：[1]山东省烟台市莱州市人民医院重症医学科,山东烟台261400

出　　处：《中外医疗》2018年第5期94-96,共3页China & Foreign Medical Treatment

摘　　要：目的分析探讨连续性血液净化(CBPT)在ICU多器官功能障碍综合征(MODS)合并急性肾衰竭(ARF)患者的应用价值。方法方便选取该院2016年1月—2017年1月收治ICU多器官功能障碍综合征合并急性肾衰竭的120例患者进行连续性血液净化治疗,分析其治疗前后的临床变化情况。结果 120例患者在治疗前脏器衰竭数为2~7个,平均为(4.3±0.3)个。患者肾外脏器衰竭占比最高的是肺(90.8%)、其次是心(65.8%)。治疗后,120例患者中病情好转且转出ICU的42例(35.0%),在ICU死亡的患者69例(57.5%),放弃治疗且出院的9例(7.5%)。治疗后患者的中心静脉压(13.2±5.1)cm H2O和血肌酐水平(327.1±160.8)μmol/L显著低于治疗前,但多巴胺用量(5.1±7.6)μg/(kg·min)以及血乳酸水平(3.8±3.2)mmol/L高于对照组,差异有统计学意义(P<0.05)。结论采用CBPT对MODS合并ARF患者进行治疗可以及早预防患者的病情,改善预后效果。Objective This paper tries to investigate the application value of continuous blood purification(CBPT)in patients with ICU multiple organ dysfunction syndrome(MODS)complicated with acute renal failure(ARF).Methods A total of 120 patients with ICU complicated with acute renal failure admitted to the hospital from January 2016 to January 2017 were convenient selected and enrolled.Continuous blood purification was performed to analyze clinical changes before and after treatment.Results The number of organ failure in 120 patients before treatment was 2~7,with an average of(4.3±0.3).The highest proportion of patients with renal failure was lung(90.8%),followed by heart(65.8%).After treatment,42 patients(35.0%)were admitted to the ICU in 120 patients,69 patients(57.5%)died in ICU,9 patients(7.5%)gave up treatment and discharged.After treatment,the central venous pressure(13.2±5.1)cmH2O and serum creatinine level(327.1±160.8)μmol/L were significantly lower than those before treatment,but the dopamine dosage(5.1±7.6)μg/(kg·min)and blood lactate level(3.8±3.2)mmol/L were higher than those of the control group,and there was a statistically significant difference(P<0.05).Conclusion The treatment of patients with MODS combined with ARF by CBPT can prevent the patient's condition and improve the prognosis.

关 键 词：连续性血液净化 多器官功能障碍综合征 急性肾衰竭 应用价值 

分 类 号：R459.5[医药卫生—治疗学]