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目的观察高容量血液滤过(HVHF)治疗老年多器官功能障碍综合征(MODS)的疗效及安全性。方法老年MODS患者58例,采用HVHF治疗,观察治疗前后血液生化、血气分析、氧合指数、平均动脉压(MAP)及急性生理学和慢性健康状况Ⅱ评分(APACHEⅡscores)的变化。结果 HVHF治疗后患者电解质紊乱和酸碱失衡纠正,肾功能、血气、氧合指数改善,MAP上升,APACHEⅡ评分明显下降。所有患者对HVHF治疗均耐受良好,HVHF过程中血流动力学稳定,未发现明显的副作用。结论 HVHF治疗除了能清除毒素和纠正电解质酸碱失衡以外,还能明显改善心肺功能和血气,应用于老年MODS患者是安全有效的。
Objective To observe the efficacy and safety of high-volume hemofiltration (HVHF) in the treatment of senile multiple organ dysfunction syndrome (MODS). Methods Fifty-eight elderly MODS patients were treated with HVHF. The changes of blood biochemistry, blood gas analysis, oxygenation index, mean arterial pressure (MAP) and acute physiology and chronic health status score (APACHEⅡscores) before and after treatment were observed. Results After treatment of HVHF, electrolyte imbalance and acid-base imbalance were corrected, renal function, blood gas and oxygenation index improved, MAP increased and APACHEⅡ score decreased obviously. All patients were well tolerated by HVHF and hemodynamically stable during HVHF with no apparent side effects. Conclusion HVHF treatment can not only clear the toxins and correct the acid-base imbalance of the electrolyte, but also improve the cardiopulmonary function and blood gas obviously. It is safe and effective to be used in senile patients with MODS.