中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
6期
39-41
,共3页
血液净化%老年多器官功能衰竭%临床疗效
血液淨化%老年多器官功能衰竭%臨床療效
혈액정화%노년다기관공능쇠갈%림상료효
Continuous veno-venous hemodiafiltration%Multiple organ failure in the elderly%Clinical effects
目的 观察连续性静脉-静脉血液透析滤过(CVVHDF)用于老年多器官功能衰竭(multi-ple organ failure in the elderly,MOFE)患者的临床疗效.方法 15例MOFE患者,年龄63～87(72.9±5.6)岁.观察CVVHDF治疗前后患者SIRS指标(体温、心率、呼吸、动脉血二氧化碳分压及外周血白细胞总数)的改变,监测其肾功能、电介质、动脉血气、中心静脉压的变化.结果 CVVHDF治疗后患者SIRS反应明显减轻,血管活性药物逐渐减量,13例机械通气患者6例成功撤离呼吸机,3例心跳呼吸骤停患者2例神志转清.血清尿素氮、肌酐、血钾较治疗前显著降低,低氧血症、酸中毒、心衰得到纠正,治疗前、后比较差异有显著性(P<0.05).结论 CVVHDF治疗MOFE患者,可明显抑制患者SIRS反应,全面改善心肺脑肾功能,是MOFE患者重要的治疗手段之一.
目的 觀察連續性靜脈-靜脈血液透析濾過(CVVHDF)用于老年多器官功能衰竭(multi-ple organ failure in the elderly,MOFE)患者的臨床療效.方法 15例MOFE患者,年齡63～87(72.9±5.6)歲.觀察CVVHDF治療前後患者SIRS指標(體溫、心率、呼吸、動脈血二氧化碳分壓及外週血白細胞總數)的改變,鑑測其腎功能、電介質、動脈血氣、中心靜脈壓的變化.結果 CVVHDF治療後患者SIRS反應明顯減輕,血管活性藥物逐漸減量,13例機械通氣患者6例成功撤離呼吸機,3例心跳呼吸驟停患者2例神誌轉清.血清尿素氮、肌酐、血鉀較治療前顯著降低,低氧血癥、痠中毒、心衰得到糾正,治療前、後比較差異有顯著性(P<0.05).結論 CVVHDF治療MOFE患者,可明顯抑製患者SIRS反應,全麵改善心肺腦腎功能,是MOFE患者重要的治療手段之一.
목적 관찰련속성정맥-정맥혈액투석려과(CVVHDF)용우노년다기관공능쇠갈(multi-ple organ failure in the elderly,MOFE)환자적림상료효.방법 15례MOFE환자,년령63～87(72.9±5.6)세.관찰CVVHDF치료전후환자SIRS지표(체온、심솔、호흡、동맥혈이양화탄분압급외주혈백세포총수)적개변,감측기신공능、전개질、동맥혈기、중심정맥압적변화.결과 CVVHDF치료후환자SIRS반응명현감경,혈관활성약물축점감량,13례궤계통기환자6례성공철리호흡궤,3례심도호흡취정환자2례신지전청.혈청뇨소담、기항、혈갑교치료전현저강저,저양혈증、산중독、심쇠득도규정,치료전、후비교차이유현저성(P<0.05).결론 CVVHDF치료MOFE환자,가명현억제환자SIRS반응,전면개선심폐뇌신공능,시MOFE환자중요적치료수단지일.
Objective To evaluate the clinical effects of continuous veno-venous hemodiafiltration (CVVHDF) on elder patients with multiple organ failure (MOFE). Methods Fifteen patients with MOF, aged 63-87 years old (average age was 72.9 ±5.6 years),were involved in this study. The clinical conditions of SIRS (including temperature, heart rate, respiratory rate, PaCO2 and peripheral leucocyte) were monitored after the initiation of CVVHDF. The renal function, electrolyte, blood gases, central venous pressure(CVP) were in-vestigated during CVVHDF. Results SIRS degrees in patients were all lightened after CVVHDF, vasoactive drugs were gradually raduced,6 of 13 patients were relieved of ventilator,2 of 3 patients became conscious from coma states, serum levels of urea,creatinine,electrolytes such as potassium were decreased after CBP. hypox-emia,oxidosis and heart failure were corrected (all P<0.05 compared with pre-therapy. Conclusion CVVH-DF can inhibit SIRS response in elder patients with MOF, rectify their heart and pulmonary function, keep bal-ance of electrolyte, help recover conscious from coma states.
