摘要
目的探讨连续性血液净化(CBP)治疗多器官功能障碍综合征(MODS)合并急性肾功能衰竭(ARF)患者的疗效和预后。方法我院中心ICU自2003年12月—2006年2月间,用CBP治疗30例MODS合并ARF患者,分为存活组(A组,19例)和死亡组(B组,11例),分别进行MODS评分、APACHE-Ⅱ评分、CBP距ARF和尿量<0·5ml/kg·h时间、血PH、HCO3-、血尿素氮(BUN)、血肌酐(Scr)、平均动脉压(MAP)、氧合指数等指标的比较。结果19例救治成功,11例死亡,死亡率36·7%;治疗后MODS评分、APACHE-Ⅱ评分较治疗前明显降低,A组氧合指数增高(P<0·05),其他生化指标与治疗前比较均有明显降低;治疗前B组受损的器官数明显多于A组(P<0·05),且B组距ARF和尿量<0·5ml/kg·h时间明显高于A组。结论MODS中器官损害数多的患者病死率高。对MODS合并ARF患者及早进行CBP治疗,对改善患者的预后有积极作用。
[Objective] Explore the effect and prognosis of continual blood purification（CBP） on multi-organ functional disorder syndrome（MODS） and acute renal failure（ARF）. [Method] Between Dec. 2003 and Feb. 2006, the ICU of the hospital treated 30 cases of MODS accompanied with ARF, in survival group（A, 19 cases） and death group（B, 11 ）, made respective scores to and comparison of MODS, APACHE-Ⅱ , distance between CBP and ARF, the urine content〈0.5ml/kg, h, blood PH, HCO3^- , BUN, Ser, MAP and oxygenated indexes. [Result] 19 cases were successfully cured, 11 died, the death rate 36.7 %; after treatment, the scores of MODS and APACHE-Ⅱ decreased obviously, the oxygenated ＂index rose in group A（P〈0.05 ）, other bio-chemical indexes all much lowered compared to before treatment; before treatment, the injured organs in group B were more than A（P〈 0.05）, and the time to ARF and urine 〈0.5ml/kg. h was more than A（P〈0.05）. [Conclusion] In MODS, the patients with more injured organs have higher death rate. To make early CBP therapy to MODS accompanying ARF ha- active function in improving patients＇ prognosis.
出处
《浙江中医药大学学报》
CAS
2006年第5期501-503,共3页
Journal of Zhejiang Chinese Medical University
