旭化成ACH-10改良技术在低体重儿血液滤过中的临床应用

发布时间：2018-10-26 08:18

【摘要】：目的:观察旭化成ACH-10血液净化机经适当改良后能否安全有效地用于低体重儿持续血液滤过治疗。方法:回顾性分析8例严重多脏器功能衰竭MODS的低体重儿用旭化成ACH-10血液净化机改良技术进行持续静脉静脉血液滤过（continuous venous hemofiltration，CVVHF），观察血钾、尿素氮、肌酐、乳酸等疗效指标的变化及血液滤过相关并发症的发生情况和预后等。结果:8例低体重儿均顺利置管，并予常规方式行血液滤过时均出现采血不良，无法正常转流；再采用改良技术，经泵前稀释后均顺利转流。治疗后严重酸中毒、高钾血症、高乳酸血症等内环境紊乱及肾功能得到明显改善（P＜0.01）；其中低体温1例，占12.5%；净化过程中无明显血压下降，但CVVHF治疗下机后出现血压下降1例，经积极处理后改善，，占12.5%；滤柱凝血1例，占12.5%，但滤柱寿命均大于12小时；无出血等其他并发症。结论： 1.旭化成ACH-10血液净化机经适当改良后能够安全有效地用于低体重儿血液滤过，有利于改善严重MODS低体重患儿的重要脏器功能，提高抢救成功率。 2．在特殊情况下，其他血液净化机可以借鉴此方法，经类似处理，应用于低体重儿血液净化，从而为此类患儿提供抢救时机及条件。
[Abstract]:Objective: to observe whether Asahi Cheng ACH-10 blood purification machine can be safely and effectively used in the treatment of low birth weight infants with continuous hemofiltration. Methods: eight low weight infants with severe multiple organ failure (MODS) underwent continuous venous hemofiltration (continuous venous hemofiltration,CVVHF) with the improved technique of Asahi ACH-10 blood purification machine. Blood potassium, urea nitrogen, creatinine were observed. The changes of lactic acid and the occurrence and prognosis of hemofiltration related complications. Results: all of the 8 cases of low body weight infants were placed tube successfully, and all of them had bad blood collection when they were treated with routine blood filtration, which could not be diverted normally, and then the modified technique was adopted, which was diluted before pump. After treatment, severe acidosis, hyperkalemia, hyperlactic acidemia and renal function were significantly improved (P < 0.01), among which hypothermia occurred in 1 case (12.5%). There was no significant decrease in blood pressure in the purification process, but there was a decrease in blood pressure in 1 case after CVVHF treatment, which was improved after active treatment, accounting for 12.5%, and blood clotting was found in 1 case (12.5%), but the life span of the filter column was longer than 12 hours. No other complications such as bleeding. Conclusion: 1. Asahi ACH-10 blood purification machine can be safely and effectively used for hemofiltration of low birth weight infants after proper improvement. It is helpful to improve the important organ function of severe low weight MODS children and to increase the success rate of rescue. 2. Under special circumstances, other blood purifiers can use this method for reference and apply to blood purification of low birth weight infants after similar treatment, thus providing rescue opportunity and conditions for this kind of children.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R726.9

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