| 周森王辉陈志乐王小智王朝燕.对早期多器官功能障碍综合征合并急性肾损伤患者行高容量血液滤过的
疗效[J].,2012,12(27):5309-5312 |
| 对早期多器官功能障碍综合征合并急性肾损伤患者行高容量血液滤过的
疗效 |
| The Efficiency of Early High Volume Hemofiltration to Patients withMultiple Organ Dysfunction Syndrome Combined with Acute Kidney Injury |
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| DOI： |
| 中文关键词: 高容量血液滤过 多器官功能障碍综合征 肾损伤 器官保护 |
| 英文关键词: Highvolume hemofiltration Multiple organ dysfunction syndrome Renal injury Organ protection |
| 基金项目: |
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| 中文摘要: |
| 目的：探讨合并有急性肾损伤(AKI)的多器官功能障碍综合征(MODS)患者早期行高容量血液滤过(HVHF)治疗后对器官保
护作用。方法：选择重症监护室于2008 年6-2012 年1 月收治的MODS 合并AKI 并接受HVHF 治疗的患者86 例作为研究对象。
根据RIFLE 分级分为Risk 组10 例，Injury 组17 例，Failure 组59 例。记录患者HVHF 治疗前后血肌酐(SCr)、氧合指数
(PaO2/FiO2)、血管外肺水指数(EVLWI)、动脉血乳酸(Lac)、凝血酶原时间(PT)、天冬氨酸转氨酶(AST)、急性生理学与慢性健康状况
评分系统Ⅱ(APACHEⅡ)评分以及28 天存活率。结果：HVHF 治疗后，Failure 组SCr、EVLWI、Lac、PT、AST、APACHEII 评分均显
著高于Risk 组和Injury 组，PaO2/FiO2 显著低于Risk 组和Injury 组，差异有统计学意义(P<0.05)。Risk 组和Injury 组在HVHF 治疗
后各指标差异均无统计学意义(P>0.05)。Risk 组28 天存活率为60.0%，Injury 组64.71%，Failure 组存活率为66.10%，3 组间差异
均无统计学意义(P>0.05)。结论：早期HVHF 治疗对MODS 合并AKI 患者的器官具有保护作用，值得临床进一步研究。 |
| 英文摘要: |
| Objective: To investigate the efficiency of early high volume hemofiltration (HVHF) to patients with multiple organ
dysfunction syndrome (MODS) combined with acute kidney injury (AKI). Methods: 86 patients with MODS combined with AKI and
treated by HVHF in our hospital were involved into this study during June 2008-January 2012. They were divided into the Risk group
with 10 cases, Injury group with 17 cases, and Failure group with 59 cases according to RIFLE. Serum creatinine (SCr), oxygenation
index (PaO2/FiO2), extravascular lung water index (EVLWI), lactate (Lac), prothrombin time (PT), aspartate aminotransferase (AST),
Acute Physiology And Chronic Health Evaluation System II (APACHE II) and 28-day survival rate before and after HVHF treatment
were recorded. Results: SCr, EVLWI, Lac, PT, AST, APACHEII in the Failure group were significantly higher than those in the Risk
group and Injury group after HVHF treatment. PaO2/FiO2 in the Failure group was significantly lower than the Risk Group and Injury
group. The differences were statistically significant (P<0.05). The differences of indexes in the Risk Group and Injury group after HVHF
treatment were not statistically significant the (P>0.05). The 28-day survival rate in the Risk Group was 60.0%. It was 64.71% in the
Injury group, and 62.71% in the Failure group. The differences among the three groups were not statistically significant (P>0.05).
Conclusions: HVHF treatment was effective to protect the organs of patients with early MODS combined with AKI. It was suggested to
take further clinical studies. |
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