连续性静脉―静脉血液滤过治疗多器官功能障碍综合征的应用研究.docVIP

连续性静脉―静脉血液滤过治疗多器官功能障碍综合征的应用研究 　　[摘要] 目的 探讨连续性静脉-静脉血液滤过（CVVH）治疗重症多发性创伤（SMI）导致的多器官功能障碍综合征的临床效果。 方法 选取本院2011年1月～2014年1月收治的100例重症多发性创伤患者作为研究对象，随机分为对照组和观察组，各50例。对照组给予常规综合治疗，观察组在对照组的基础上采用CVVH治疗。观察两组治疗前后的肌酐（SCr）、尿素氮（BUN）、K+、Na+和HCO3-水平，并比较两组治疗前后的APACHE Ⅱ、MODS和SOFA评分。 结果 观察组治疗后的SCr、BUN、K+、Na+水平显著低于对照组治疗后，HCO3-水平显著高于对照组治疗后，差异有统计学意义（P0.05）。观察组治疗后的APACHE Ⅱ、MODS及SOFA评分显著低于对照组，差异有统计学意义（P0.05）。观察组的病死率显著低于对照组，差异有统计学意义（P0.05）。 结论 CVVH可通过下调炎症介质而调控机体的炎性反应，能够明显改善机体内各脏器组织的生理学功能。 　　[关键词] 连续性静脉-静脉血液滤过；多发性损伤；全身炎性反应综合征 　　[中图分类号] R459.5 [文献标识码] A [文章编号] 1674-4721（2015）07（b）-0037-04 　　[Abstract] Objective To explore the clinical effect of continuous venovenous hemofiltration （CVVH） in the treatment of multiple organ dysfunction syndrome caused by severe multiple trauma （SMI）. Methods 100 cases with severe multiple trauma in our hospital from January 2011 to January 2014 were selected and randomly divided into the control group and the observation group according to different treatment methods，50 cases in each group.The control group was treated with conventional treatment，the observation group was given CVVH treatment on the basis of the control group.The level of serum creatinine （SCr），urea nitrogen （BUN），K+，Na+ and HCO3- in two groups before and after treatment was observed，and the score of APACHE Ⅱ，MODS and SOFA in two groups before and after treatment was compared. Results The level of SCr，BUN，K+，Na+ in the observation group after treatment was lower than that in the control group after treatment，the level of HCO3- in the observation group after treatment was higher than that in the control group after treatment，with significant difference（P0.05）.The score of APACHE Ⅱ，MODS and SOFA in the observation group after treatment was lower than that in the control group after treatment，with significant difference（P0.05）.The mortality rate in the observation group was lower than that in the control group，with significant difference（P0.05）. Conclusion CVVH can significantly improve the phy