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目的 探讨血液滤过在多器官功能障碍综合征 (MODS)治疗中的应用。方法 选择符合MODS诊断标准的患者 19例 ,在进行综合治疗的基础上行连续性静脉 -静脉血液滤过 (CVVH )治疗 ,于血液滤过前及滤过后 8小时 ,分别取静脉血测血液电解质、肾功能和有关细胞因子 ,动脉血做血气分析 ,其中采用ELISA法测定有关细胞因子。结果 19例患者血液血滤过后血清BUN、SCr、K+ 、Na+ 、Cl-无明显下降 ,血浆TNF -α、IL -2、水平明显下降 ,IL -8水平在CVVH前后无统计学差异 (P >0 0 5 ) ,与血液滤过前比较 ,血滤过程中患者心率 (HR)显著下降 ,平均动脉压 (MAP)明显升高 ,整个血滤过程中PaO2 ,PaO2 /FiO2 升高明显 ,但PaCO2 无明显变化。结论 CVVH可清除MODS患者血浆中部分细胞因子 ,并可改善血流动力学及氧合功能。
Objective To investigate the application of hemofiltration in the treatment of multiple organ dysfunction syndrome (MODS). Methods Nineteen patients who met MODS criteria were enrolled in the study. Continuous veno-venous hemofiltration (CVVH) was performed on the basis of comprehensive treatment. Blood samples were collected before venous filtration and eight hours after filtration. Renal function and related cytokines, arterial blood gas analysis, which used ELISA to determine the relevant cytokines. Results The serum levels of BUN, SCr, K +, Na + and Cl- in 19 patients after blood filtration were significantly lower than those before CVVH (P> 0.05). There was no significant difference in the levels of IL-8 and TNF- Compared with before hemofiltration, heart rate (HR) decreased significantly and mean arterial pressure (MAP) increased significantly during the process of hemofiltration. PaO2 and PaO2 / FiO2 increased significantly during the whole process of hemofiltration. PaCO2 No significant changes. Conclusion CVVH can clear some of the plasma cytokines in patients with MODS, and can improve hemodynamics and oxygenation function.