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目的:探讨血液透析对急性肾功能衰竭伴多脏器损害(MODS)的治疗效果。方法:总结我院1996～1998年合并肾衰的多脏器损害病人17例,采用碳酸盐法血液透析及综合病因治疗,观察治疗后转归情况。结果:17例经治疗后存活12例,死亡5例,总死亡率30%。随衰竭脏器增多,死亡率逐渐增多。其中2个脏器损害8例,死亡2你,存活6例,死亡率25%;3个脏器损害5例,存活3例,死亡2例,死亡率40%;5个脏器损害2例,存活1例,死亡1例,死亡率50%。结论:血液透析在治疗急性肾功能衰竭,纠正水电解质紊乱、酸碱平衡失调,排除水钠潴留、毒素蓄积,控制心衰、肺水肿的同时延缓了MODS病情进展,提高了MODS的存活率。
Objective: To investigate the therapeutic effect of hemodialysis on acute renal failure with multiple organ damage (MODS). Methods: In our hospital from 1996 to 1998 combined with renal failure in multiple organ damage in 17 patients, the use of carbonated hemodialysis and comprehensive treatment of etiology, observation of outcome after treatment. Results: Seventeen survived in 12 cases and 5 died, with a total mortality of 30%. With the failure of organs increased, the mortality rate gradually increased. Among them, two organs were damaged in 8 cases, 2 died and 6 survived, with a mortality rate of 25%. Three organs were damaged in 5 cases, 3 survived and 2 died, with a mortality rate of 40%. Five organs were damaged in 2 cases , 1 patient survived, 1 patient died and the mortality rate was 50%. Conclusion: Hemodialysis can delay the progression of MODS and improve the survival rate of MODS in the treatment of acute renal failure, correct water-electrolyte disturbance, acid-base balance disorders, exclude water-sodium retention, toxin accumulation, control heart failure and pulmonary edema.