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目的探讨连续性血液净化(CBP)治疗糖尿病并发不同严重并发症患者中的应用价值。方法对晋江市医院2003年3月-2010年3月收治的13例糖尿病并发严重感染诱发多脏器功能障碍综合征(MODS)、糖尿病肾病伴全身顽固性浮肿、双胍类药物相关性严重乳酸酸中毒的临床资料进行回顾性分析。均在常规治疗的基础上应用连续性静脉-静脉血液滤过(CVVH)治疗,观察分析患者治疗前后生命征和血生化指标、二氧化碳结合力(CO2CP)、血pH的变化以及患者的死亡率。结果患者治疗前后血压、脉搏、呼吸平稳,血乳酸和血钾下降、血CO2CP和pH上升均有明显效果。存活12例,1例乳酸酸中毒的尿毒症患者因腹壁血管破裂大出血、失血性休克死亡。结论应用CBP治疗能改善糖尿病并发药物治疗效果差的严重并发症患者的内环境,维持酸碱平衡,按个体化治疗方案,能改善患者的预后。
Objective To investigate the value of continuous blood purification (CBP) in the treatment of diabetic patients with severe complications. Methods Thirteen cases of diabetic complicated with severe organ dysfunction syndrome (MODS), diabetic nephropathy with systemic refractory edema, biguanate-related serious lactic acid Poisoning clinical data for retrospective analysis. Continuous veno-venous hemofiltration (CVVH) was used on the basis of routine treatment. Changes of vital signs and blood biochemical parameters, carbon dioxide binding (CO2CP), blood pH, and patient’s mortality before and after treatment were observed and analyzed. Results Before and after treatment of patients with blood pressure, pulse, breathing steady, blood lactate and potassium decreased, blood CO2CP and pH have a significant effect. Survival in 12 cases, 1 case of lactic acidosis in uremic patients due to abdominal vascular rupture bleeding, hemorrhagic shock and death. Conclusion The application of CBP can improve the internal environment of patients with severe complications of diabetes complicated with poor drug treatment and maintain the acid-base balance. Individualized treatment can improve the prognosis of patients.