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目的探讨连续性血液净化(CBP)用于治疗多器官功能障碍综合征(MODS)的疗效。方法以2014年5月至2016年6月我院收治的36例MODS患者为研究对象,均在常规治疗基础上联合CBP,观察接受治疗后患者生命体征、血流动力学参数、生化指标[血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、血尿素氮(BUN)和血肌酐(Cr)]、多巴胺使用剂量,及血清炎性因子浓度的变化。结果治疗过程中,生存29例,死亡5例,因经济困难放弃治疗2例;接受CBP治疗后,患者的平均动脉压(MAP)、血氧合指数(PO2/Fi O2)较治疗前显著升高,血管活性药多巴胺用量减少(P<0.05);治疗后BUN、ALT、AST和Cr与治疗前比较均显著降低(P<0.05);CBP治疗开始后血浆白细胞介素(IL)-6、IL-8、IL-10均显著低于治疗前(P<0.05)。结论 CBP化能重新平稳MODS患者的内环境稳态,改善重要脏器功能,临床效果显著。
Objective To investigate the efficacy of continuous blood purification (CBP) in the treatment of multiple organ dysfunction syndrome (MODS). Methods From May 2014 to June 2016, 36 patients with MODS were enrolled in our hospital. All of them were treated with CBP on the basis of conventional therapy. The vital signs, hemodynamic parameters, biochemical indexes [serum Alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN) and serum creatinine (Cr)], dopamine dosage and serum inflammatory cytokines. Results In the course of treatment, 29 patients survived and 5 died, giving up treatment for 2 due to financial difficulties. After receiving CBP, mean arterial pressure (MAP) and oxygenation index (PO2 / Fi O2) were significantly higher than those before treatment (P <0.05). After treatment, the levels of BUN, ALT, AST and Cr were significantly lower than those before treatment (P <0.05). After the treatment of CBP, the levels of plasma interleukin (IL) -6, IL-8, IL-10 were significantly lower than before treatment (P <0.05). Conclusion CBP can re-stabilize the homeostasis of MODS patients and improve the function of vital organs. The clinical effect is significant.