血液灌流\血液透析联合纳洛酮治疗多脏器功能衰竭的临床研究
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[摘要] 目的:探讨血液灌流、血液透析联合纳洛酮治疗多脏器功能衰竭(MOF)的临床疗效,以进一步指导临床治疗。方法:将我院2006年1月～2009年10月收治的60例MOF患者随机分为对照组(常规治疗组)和治疗组(联合治疗组),观察比较两组的用药量、用药次数和治愈率。结果:治疗组用药量、用药次数较对照组明显降低(P<0.05),但治疗组的治愈率明显高于对照组(P<0.05)。结论:血液灌流、血液透析联合纳洛酮治疗不失为一种治疗MOF的有效方法,但应尽早进行。
[关键词] 血液灌流;血液透析;纳洛酮
[中图分类号] R459.5[文献标识码]A [文章编号]1673-7210(2010)06(c)-044-02
Clinical research of hemoperfusion, hemodialysis combined with naloxoneon the treatment of multiple organ failure
LI Jiwen
(Department of Emergency, the First People's Hospital of Hechi City, Hechi 546300, China)
[Abstract] Objective: To evaluate the clinical effects of the hemoperfusion, hemodialysis combined naloxone on the treatment of multiple organ failure (MOF) in order to further guide clinical treatment. Methods: From January 2006 to October 2009, 60 cases of (MOF) patients were randomly divided into control group (routine treatment): anti-infectives, including antibiotics, rehydration and give corrective acid, to maintain water and electrolyte balance, nutritional support for treatment symptomatic treatment of the primary disease and the important organs support; the treatment group: based on the control group, the increase of hemorerfusion dialysis plus naloxone in 30 cases, to compare the dosage, medication frequency and cure rate between two groups. Results: The dosage, medication frequency and medication of the treatment group were significantly lower compared with control group (P<0.05), but the cure rate of the treatment group was significantly higher than that of control group (P<0.05). Conclusion: Hemoperfusion, hemodialysis combined with naloxone on the treatment of MOF is an effective method, but should be soon as possible.
[Key words] Hemoperfusion; Hemodialysis; Naloxone
血液灌流联合血液透析可以提高患者的治愈率,降低病死率,不良反应极小,对多器官功能衰竭(MOF)的患者具有重要的临床意义。本文对我院2006年1月～2009年10月急诊科ICU收治的60例MOF患者采用血液灌流、血液透析联合纳洛酮治疗,并观察其临床疗效。现报道如下:
1 资料与方法
1.1 一般资料
60例MOF患者中,男32例,女28例;年龄16～64岁;MOF毒物种类:砷化氢30例,鱼胆15例,蜂蜇伤5例,原因不明10例;并发意识障碍27例,肝肾功能损害19例。将60例患者随机分为两组,各30例。治疗组(联合治疗组)30例中,男13例,女17例,年龄18～52岁,平均37岁;对照组(常规治疗组)30例中,男14例,女16例,年龄16～54岁,平均35岁。两组患者在性别、年龄等方面比较差异无统计学意义(P>0.05),具有可比性。
1.2 治疗方法
对照组:包括应用抗生素抗感染、补液、给予纠酸、维持水电解质平衡、营养对症治疗等治疗原发病及各重要脏器支持治疗等。
治疗组:在对照组治疗的基础上采用血液灌流透析加纳洛酮治疗。灌流器串联在透析器之前,应用爱尔血液净化器材厂生产的YTS.160.或150.及100.灌流器,血液灌流器与德国FreseniusF6聚砜膜透析器通串联,血流量为200～250 ml/min,联合治疗2.0 h后,将灌流器取下,继续单纯透析治疗至4.5 h。透析器为德国贝朗710500R透析机,应用碳酸氢盐缓冲液,透析液流速为500 ml/min。均采用普通肝素抗凝,化验标本在静脉应用肝素之前采血。纳洛酮4 mg(国药准字H20061204,北京四环制药厂生产)加入10%葡萄糖液500 ml中静脉滴注,维持24 h,连续3 d。观察并比较两组的用药量、用药次数和治愈率。
1.3 统计学分析
采用SPSS 11.0软件进行统计学分析,采用t检验及χ2检验 ......
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