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中国人民解放军总医院
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中国人民解放军总医院老年心血管病研究所
中国科技出版传媒股份有限公司
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中华老年多器官疾病杂志编辑委员会
100853, 北京市复兴路28号
电话:010-66936756
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E-mail: zhlndqg@mode301.cn
创刊人 王士雯
总编辑 范利
副总编辑 陈韵岱
执行主编 叶大训
编辑部主任 王雪萍
ISSN 1671-5403
CN 11-4786
创刊时间 2002年
出版周期 月刊
邮发代号 82-408
友情链接
贡歌,张兴虎,张瑗,杨翔,周诗,万文辉.连续静脉-静脉血液滤过对高龄老年多器官功能衰竭患者的疗效[J].中华老年多器官疾病杂志,2021,20(10):745~748
连续静脉-静脉血液滤过对高龄老年多器官功能衰竭患者的疗效
Efficacy of continuous venous-venous hemofiltration in treatment of the elderly with multiple organ failure
投稿时间:2021-03-09  
DOI:10.11915/j.issn.1671-5403.2021.10.155
中文关键词:  老年人;连续静脉-静脉血液滤过;多器官功能衰竭;疗效
英文关键词:aged; continuous venous-venous hemofiltration; multiple organ failure; therapeutic efficacy This work was supported by the Special Scientific Research Project for Military Healthcare
基金项目:军队保健专项科研课题(17BJZ17)
作者单位E-mail
贡歌 中国人民解放军东部战区总医院干部病房一科,南京210002  
张兴虎 中国人民解放军东部战区总医院干部病房一科,南京210002  
张瑗 中国人民解放军东部战区总医院干部病房一科,南京210002  
杨翔 中国人民解放军东部战区总医院干部病房一科,南京210002  
周诗 中国人民解放军东部战区总医院干部病房一科,南京210002  
万文辉 中国人民解放军东部战区总医院干部病房一科,南京210002 wanwhnj@sina.com 
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中文摘要:
      目的 探讨连续静脉-静脉血液滤过(CVVH)治疗高龄老年多器官衰竭(MOFE)患者的效果与安全性。方法 回顾性分析2010年1月至2020年12月东部战区总医院老年病房诊治的多器官功能衰竭33例患者的临床资料。按照存活时间是否超过15d,分为存活组(18例)和死亡组(15例)。收集患者的年龄、衰竭器官数量、血生化指标、动脉血气、治疗方法及死亡时间等指标。采用SPSS 22.0软件进行数据分析。结果 所有患者均为股静脉置管,有4例发生导管感染。存活组与死亡组患者的年龄、CVVH前的血尿素氮、肌酐、电解质、脑利钠肽前体、动脉血pH值、全血剩余碱比较,差异均无统计学意义(均P>0.05);存活组与死亡组乳酸[(2.32±1.17)和(5.00±4.35)mmol/L]、24h尿量[(501.17±229.62)和(220.33±191.68)ml]、衰竭器官个数[(3.33±1.14)和(4.33±1.15)个]比较,差异均有统计学意义(均P<0.05)。CVVH治疗前后尿素氮[(34.27±13.54)和(15.77±9.15)mmol/L]、血肌酐[(347.57±170.22)和(165.55±89.32)μmol/L]、脑利钠肽前体[(2128.27±1416.08)和(1181.86±1 305.17)pmol/L]、血钾[(4.78±1.03)和(4.12±0.56)mmol/L]、动脉血pH值[(7.28±0.12)和(7.33±0.12)]比较,差异均有统计学意义(均P<0.05),治疗前后血钠、钙、磷、全血剩余碱及乳酸变化不明显(P>0.05)。结论 CVVH治疗有助于改善高龄老年多器官功能衰竭患者的预后,能明显减轻高龄患者心脏负荷、加快小分子毒素的清除、维持电解质和酸碱度的平衡。
英文摘要:
      Objective To investigate the efficacy and safety of continuous venous-venous hemofiltration (CVVH) in the treatment of multiple organ failure in the elderly (MOFE). Methods Clinical data of 33 elderly patients with MOFE who underwent CVVH treatment in our hospital from January 2010 to December 2020 were collected and retrospectively analyzed in this study. According to their survival time longer than 15 d or not, they were divided into survival group (n=18) and death group (n=15). Their age, number of failed organs, blood biochemical indicators, arterial blood gas parameters, treatment methods, death time and other indicators were analyzed. SPSS statistics 22.0 was used for statistical analysis. Results All patients had femoral vein catheterization, and 4 cases experienced catheter infection. There were no significant differences in age, serum levels of urea nitrogen, creatinine, electrolytes and pro-brain natriuretic peptide, arterial blood pH value, and residual alkali between the two groups (all P>0.05). Obvious differences were seen in lactic acid level [(2.32±1.17) vs (5.00±4.35) mmol/L], 24-hour urine volume [(501.17±229.62) vs (220.33±191.68) ml] and number of failed organs [(3.33±1.14) vs (4.33±1.15), all P<0.05]. Urea nitrogen [(34.27±13.54) vs (15.77±9.15) mmol/L], serum creatinine [(347.57±170.22) vs (165.55 ± 89.32) μmol/L], pro-brain natriuretic peptide [(2 128.27±1 416.08) vs (1 181.86±1 305.17) pmol/L], blood potassium [(4.78±1.03) vs (4.12±0.56) mmol/L], arterial blood pH value [(7.28±0.12) vs (7.33±0.12)] were statistically significant before and after CVVH treatment (all P<0.05). But no such differences were found in blood sodium, calcium, phosphorus, residual alkali and lactic acid before and after treatment (P>0.05). Conclusion CVVH treatment is significantly helpful for improving the prognosis, reducing the heart loading, accelerating the removal of small molecule toxins, and maintaining the balance of electrolytes and pH value in the elderly patients with MOFE.
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