组合式血液净化治疗MODS的病例报告
发布时间：2019-02-24 10:55
【摘要】：多器官功能障碍综合征(MODS)是ICU患者死亡的主要原因之一,目前仍是危重症医学专业研究的重点和难点,在近些年的研究和临床实践中,血液净化技术为多器官功能不全的治疗提供了新的思路和方法,本文回顾性的报道和分析了我科收治的四份病历,它们分别因爆发性心肌炎、HIV感染为基础疾病继发感染、重症急性胰腺炎、中毒可能的疾病发展为MODS的患者,在病情发展过程中出现了两个或两个以上器官功能的受损或不全,尤其以肝、肾功能不全为突出表现即丙氨酰氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TB)、尿素(Urea)和肌酐(Cre)等生化指标异常升高,我们给予CWH血液净化的基础上,根据病人情况分别联合了血浆置换或胆红素吸附治疗,虽然患者的最终死亡率无明显改善,但这四例患者在综合治疗中采用组合式血液净化技术后患者相应器官的生化指标基本恢复正常,同时病情得到明显的改善,其中三例患者最终死于原发病。结论：组合式血液净化能有效改善多器官功能障碍情况,但如果原发病情况不能得到有效控制,那么死亡率仍然不能得到有效改善。
[Abstract]:Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in ICU patients. Blood purification technology provides a new way of thinking and method for the treatment of multiple organ dysfunction. This paper reviews and analyzes four medical records in our department. They are secondary infections due to outbreak myocarditis and HIV infection, respectively. In patients with severe acute pancreatitis, a potentially toxic disease that develops into MODS, two or more organ functions are impaired or incomplete, especially in the liver. Renal insufficiency was characterized by abnormal elevation of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), urea (Urea) and creatinine (Cre). On the basis of CWH blood purification, we combined plasma exchange or bilirubin adsorption therapy according to the patient's condition, although there was no significant improvement in the final mortality of the patient. But after the combined blood purification technique was used in the four patients, the biochemical indexes of the corresponding organs were basically restored to normal, and the condition of the patients was obviously improved. Three of the patients died of the primary disease. Conclusion: combined blood purification can effectively improve the condition of multiple organ dysfunction, but if the primary disease can not be effectively controlled, then the mortality can not be effectively improved.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R459.7
本文编号：2429487
[Abstract]:Multiple organ dysfunction syndrome (MODS) is one of the leading causes of death in ICU patients. Blood purification technology provides a new way of thinking and method for the treatment of multiple organ dysfunction. This paper reviews and analyzes four medical records in our department. They are secondary infections due to outbreak myocarditis and HIV infection, respectively. In patients with severe acute pancreatitis, a potentially toxic disease that develops into MODS, two or more organ functions are impaired or incomplete, especially in the liver. Renal insufficiency was characterized by abnormal elevation of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TB), urea (Urea) and creatinine (Cre). On the basis of CWH blood purification, we combined plasma exchange or bilirubin adsorption therapy according to the patient's condition, although there was no significant improvement in the final mortality of the patient. But after the combined blood purification technique was used in the four patients, the biochemical indexes of the corresponding organs were basically restored to normal, and the condition of the patients was obviously improved. Three of the patients died of the primary disease. Conclusion: combined blood purification can effectively improve the condition of multiple organ dysfunction, but if the primary disease can not be effectively controlled, then the mortality can not be effectively improved.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R459.7
【参考文献】
相关期刊论文 前2条
1 张延龄;多器官功能不全综合征[J];创伤外科杂志;2001年01期
2 周高生;姚华国;邓烈华;;脓毒症时血管内皮细胞连接变化的研究进展[J];广东医学院学报;2013年03期
，本文编号：2429487
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