高容量血液滤过联合体外膜肺对多器官功能障碍综合征患者的治疗作用
陶立坚 张军 艾宇航 赵双平 蔡宏伟 宁建平 许辉 【摘要】 目的 探讨高容量血液滤过(HVHF)联合体外膜肺(ECMO)对多器官功能障碍综合征(MODS)患者低氧血症和肾功能的影响。方法 8例确诊为合并急性呼吸窘迫综合征(ARDS)和急性肾功能衰竭(ARF)的MODS患者，均应用HVHF联合ECMO治疗和HVHF单独治疗各8 h，观察治疗过程中患者氧分压(PO2)、脉搏血氧饱和度(SpO2)、二氧化碳分压(PCO2)的变化以及对肾功能的影响。结果经HVHF联合ECMO治疗后，患者PO2和SpO2明显上升，治疗后1、4和8 h患者PO2与治疗前比较有统计学意义(P均<0.05)，治疗后4 h和8 h患者SpO2与治疗前比较有统计学意义(P均<0.05)，而HVHF治疗过程中患者PO2、SpO2及PCO2无明显变化(P均>0.05)。HVHF联合ECMO或HVHF单独治疗均能明显降低患者血尿素氮和肌酐水平(P均<0.05)。结论 HVHF联合ECMO治疗能明显改善MODS患者的缺氧和低氧血症，有益于MODS的恢复。
【关键词】 高容量血液滤过； 体外膜肺； 多器官功能障碍综合征
Extracorporeal membrane oxygenation treatment with high-volume hemofiltration in patients with multiple organ dysfunction syndrome
TAO Li-jian, ZHANG Jun, AI Yu-hang, ZHAO Shuang-ping, CAI Hong-wei, NING Jian-ping, XU Hui.
Department of Nephrology, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
【Abstract】 Objective：To evaluate whether extracorporeal membrane oxygenation (ECMO) with high-volume hemofiltration (HVHF) improves hypoxemia and renal function in patients with multiple organ dysfunction syndrome (MODS).Methods：The study was executed in 8 MODS patients with acute respiratory distress syndrome (ARDS) and acute renal failure (ARF). They were randomly assigned to either 8 hours of HVHF combined with ECMO or HVHF alone in random order. The changes in arterial oxygen pressure(PO2), pulse oxygen saturation (SpO2), arterial carbon dioxide pressure (PCO2), serum creatinine(SCr) and blood urea nitrogen(BUN) levels were measured. Results： Compared with that of before the treatment, PO2 was increased significantly at 1, 4, 8 hours, and SpO2was increased significantly at 4, 8 hours after ECMO with HVHF in MODS patients, the changes of PO2, SpO2and PCO2 were not significantly during HVHF(all P>0.05). The average concentrations of BUN and SCr were decreased significantly after HVHF or HVHF with ECMO therapy in MODS patients. Conclusion： HVHF with ECMO, which can improve hypoxemia significantly, may be a better option for the treatment of MODS patients. ......
您现在查看是摘要页，全文长 10567 字符。