CAJ | 학술논문

目的探讨连续性静脉-静脉血液滤过(CVVH)对多器官功能障碍综合征(MODS)患者的治疗作用及临床监护要点.方法对22例MODS患者经中心静脉插管留置单针双腔导管,使用BRAUN Diapact CRRT机行CVVH方式治疗.于治疗前后30 min抽取静脉血,检测尿素氮(BUN)、血清肌酐(Scr)及血清K+的浓度,采用ELISA法测定血浆肿瘤坏死因子α(TNF-α)、白细胞介素1(IL-1)、白细胞介紊8(IL-8),同时抽取动脉血进行血气分析.并对治疗过程中生命体征进行监测.结果所有患者的CVVH治疗过程中生命体征稳定.CVVH后血清BUN、Scr、K+均逐渐下降,与治疗前比较差异显著,血浆TNF-α、IL-1、IL-8水平均逐渐降低,与治疗前比较差异显著.结论 CVVH能改善血液生化指标,能清除血浆中多种细胞因子,且治疗过程中生命体征稳定,适用于MODS的治疗.
목적 탐토련속성정맥-정맥혈액려과(CVVH)대다기관공능장애종합정(MODS)환자적치료작용급림상감호요점.방법 대22례MODS환자경중심정맥삽관류치단침쌍강도관,사용BRAUN Diapact CRRT궤행CVVH방식치료.우치료전후30 min추취정맥혈,검측뇨소담(BUN)、혈청기항(Scr)급혈청K+적농도,채용ELISA법측정혈장종류배사인자α(TNF-α)、백세포개소1(IL-1)、백세포개문8(IL-8),동시추취동맥혈진행혈기분석.병대치료과정중생명체정진행감측.결과 소유환자적CVVH치료과정중생명체정은정.CVVH후혈청BUN、Scr、K+균축점하강,여치료전비교차이현저,혈장TNF-α、IL-1、IL-8수평균축점강저,여치료전비교차이현저.결론 CVVH능개선혈액생화지표,능청제혈장중다충세포인자,차치료과정중생명체정은정,괄용우MODS적치료.
Objective To investigate the effect and monitoring point of continuous veno-venous hemofil-tration (CVVH) in patients with multiple organ dysfunction syndrome (MODS). Methods In 22 patients with MODS,a double lumen catheter was put into the central vein,and the CWH was performed with the BRAUN Diapact CRRT. The level of BUN,Scr,serum potassium and arterial blood gas were measured 30 minutes before and after CVVH. The plasma TNF-α、IL-1、IL-8 were measured by ELISA. Vital signs were monitored dur-hag treatment process. Results The vital signs of all patients` was stable, the levels of BUN,Scr and serum potassium decreased significantly after CVVH. The plasma concentrations of TNF-α,IL-1 and IL-8 gradually decreased. Conclusions CWH can improve the blood biochemical markers,remove inflammatory cytokines in plasma,stsblize the vital signs during treatment,which is suitable for patients with MODS.