连续性血液净化对多器官功能障碍综合征患者评分和凝血功能的影响  

Effects of continuous blood purification on critical scores and coagulopathy in patients with multiple organ dysfunction syndrome

作　　者：王锦权[1] 赵劲松[1] 潘爱军[1] 高玉华[1] 承韶辉[1] 

机构地区：[1]安徽省立医院ICU,合肥230001

出　　处：《中华急诊医学杂志》2003年第2期79-81,共3页Chinese Journal of Emergency Medicine

摘　　要：目的　对连续性血液净化 (CBP)治疗多器官功能障碍综合征 (MODS)的效果进行研究 ,同时对MODS患者的凝血功能紊乱与危重症评分的相关性进行探讨。方法　选用APACHEⅡ评分、MODS评分、SAPSⅡ评分和TISS评分系统对MODS患者病情严重性和群体病员死亡风险率进行评估 ,比较治疗前、后各评分结果 ,并将治疗前、后患者的各评分与凝血参数中PT、PT INR、APTT、Fg、TT和D D进行相关性分析。结果　APACHEⅡ、MODS评分和SAPSⅡ ,治疗后较治疗前降低 (分别P <0 0 1,P <0 0 1和P <0 0 5 )。治疗前、后凝血参数间进行比较 ,仅仅D D治疗后降低较治疗前差异有非常显著意义 (P <0 0 1)。治疗前、后APACHEⅡ、MODS评分、SAPSⅡ和TISS均与有关凝血参数存在显著相关性。结论　CBP是治疗MODS的有效手段之一 ;CBP治疗过程中抗凝技术的使用 ,对患者凝血 纤溶系统的平衡的恢复起着积极作用。Objectives To study effects of continuous blood purification(CBP)on multiple organ dysfunction syndrome(MODS),and correlation between coagulopathy and critical scores.Methods APACHEⅡ,MODS,SAPS and TISS were used for evaluating severity and risk of all patients with MODS.Scores of pre-and post-therapy and correlation with PT,PT-INR,APTT,Fg,TT and D D were comparaed.Results APACHEⅡ,MODS,and SAPS of post-therapy were lower than those of pre-therapy(P<0 01,P<0 01,P<0 05,respectively),D D of post-therapy was also lower (P<0 01);the critical scores were significantly correlated to some results of blood coagulation.Conclusion CBP was effective in patients with MODS.Anticoagulants used during CBP may have an active role in recovering the balance between blood coagulation and fibrinolysis system. [

关 键 词：多器官功能障碍综合征 连续性血液净化疗法 治疗 凝血功能紊乱 危重症评分 相关性 

分 类 号：R459.5[医药卫生—治疗学]