国际医药卫生导报
國際醫藥衛生導報
국제의약위생도보
INTERNATIONAL MEDICINE & HEALTH GUIDANCE NEWS
2012年
21期
3176-3179
,共4页
吴志雄%冯坤好%杨博%叶光福
吳誌雄%馮坤好%楊博%葉光福
오지웅%풍곤호%양박%협광복
持续静-静脉血液滤过%多脏器功能衰竭%血流动力学
持續靜-靜脈血液濾過%多髒器功能衰竭%血流動力學
지속정-정맥혈액려과%다장기공능쇠갈%혈류동역학
Continuous veno-venous hemofiltration%Multiple organ dysfunction syndrome%Hemodynamics
目的 观察分析MODS(多脏器功能障碍综合征)患者应用连续性静-静脉血液滤过治疗的疗效和对血流动力学的影响.方法 选择我院由各种病因导致的MODS32例患者,全 部病例均给予连续性静-静脉血液滤过(CVVH)治疗,并检测CVVH前、后血肾功能及电解质和动脉血气.利用美国BioZ(R)无创心脏动力学系统监测血流动力学改变.结果 CVVH治疗过程中,患者APACHEⅡ评分有下降趋势,并渐趋正常,与治疗前比较,差异有显著性(P＜0.05).治疗前患者肾功能BUN、SCr和血清钾高,CVVH治疗后BUN、SCr和血清钾均明显降低.与治疗前比较,差异有显著性(P＜0.05).治疗后血清钠趋于稳定,与治疗前比较,差异有显著性(P＜0.05).CVVH治疗过程中,患者PH值渐趋正常,与治疗前比较,差异有显著性(P＜0.05).治疗前患者氧合指数PaO2/FiO2低,CVVH治疗后与治疗前比较,差异有非常显著性(P＜0.01)CVVH24 h后HR、MAP、LCWI、TFC、CO、SVR、CVP均有明显改善,TFC和SVR72h后逐渐趋向稳定,与CVVH前相比P＜0.01.结论 CVVH可有效改善肾功能,调节酸碱和电解质平衡,患者的血流动力学稳定,有利于改善患者的预后.
目的 觀察分析MODS(多髒器功能障礙綜閤徵)患者應用連續性靜-靜脈血液濾過治療的療效和對血流動力學的影響.方法 選擇我院由各種病因導緻的MODS32例患者,全 部病例均給予連續性靜-靜脈血液濾過(CVVH)治療,併檢測CVVH前、後血腎功能及電解質和動脈血氣.利用美國BioZ(R)無創心髒動力學繫統鑑測血流動力學改變.結果 CVVH治療過程中,患者APACHEⅡ評分有下降趨勢,併漸趨正常,與治療前比較,差異有顯著性(P＜0.05).治療前患者腎功能BUN、SCr和血清鉀高,CVVH治療後BUN、SCr和血清鉀均明顯降低.與治療前比較,差異有顯著性(P＜0.05).治療後血清鈉趨于穩定,與治療前比較,差異有顯著性(P＜0.05).CVVH治療過程中,患者PH值漸趨正常,與治療前比較,差異有顯著性(P＜0.05).治療前患者氧閤指數PaO2/FiO2低,CVVH治療後與治療前比較,差異有非常顯著性(P＜0.01)CVVH24 h後HR、MAP、LCWI、TFC、CO、SVR、CVP均有明顯改善,TFC和SVR72h後逐漸趨嚮穩定,與CVVH前相比P＜0.01.結論 CVVH可有效改善腎功能,調節痠堿和電解質平衡,患者的血流動力學穩定,有利于改善患者的預後.
목적 관찰분석MODS(다장기공능장애종합정)환자응용련속성정-정맥혈액려과치료적료효화대혈류동역학적영향.방법 선택아원유각충병인도치적MODS32례환자,전 부병례균급여련속성정-정맥혈액려과(CVVH)치료,병검측CVVH전、후혈신공능급전해질화동맥혈기.이용미국BioZ(R)무창심장동역학계통감측혈류동역학개변.결과 CVVH치료과정중,환자APACHEⅡ평분유하강추세,병점추정상,여치료전비교,차이유현저성(P＜0.05).치료전환자신공능BUN、SCr화혈청갑고,CVVH치료후BUN、SCr화혈청갑균명현강저.여치료전비교,차이유현저성(P＜0.05).치료후혈청납추우은정,여치료전비교,차이유현저성(P＜0.05).CVVH치료과정중,환자PH치점추정상,여치료전비교,차이유현저성(P＜0.05).치료전환자양합지수PaO2/FiO2저,CVVH치료후여치료전비교,차이유비상현저성(P＜0.01)CVVH24 h후HR、MAP、LCWI、TFC、CO、SVR、CVP균유명현개선,TFC화SVR72h후축점추향은정,여CVVH전상비P＜0.01.결론 CVVH가유효개선신공능,조절산감화전해질평형,환자적혈류동역학은정,유리우개선환자적예후.
Objective To investigate the efficacy of continuous veno-venous hemofiltration(CVVH)in the treatment of multiple organ dysfunction syndrome(MODS)and the impact of this therapy on hemodynamics.Methods 32 patients with MODS who had undergone CVVH were included in this study.Heart rate(HR),mean pulmonary arterial pressure(MAP),central venous pressure(CVP),left cardiac work index(LCWI),cardiac output(CO),systemic vascular resistance(SVR),and thoracic fluid content(TFC)were measured with the BioZ(R)Cardio Dynamics.Concentrations of BUN and SCr,and serum levels of potassium and sodium were detected before and after CVVH.Results Levels of BUN and SCr and serum potassium declined significantly 72 hours after CVVH(P＜0.05);and HR,MAP,LCWI,TFC,CO,SVR,and CVP decreased 24 hours after CVVH(P＜0.05)and then became stable at 72 hours with amelioration of PaO2/FiO2(P＜0.01).Conclusions Continuous veno-venous hemofiltration can effectively improve renal function,regulate acid-base and electrolyte balance,and maintain stability of hemodynamics in patients;thus it is beneficial for improvement in prognosis.
