中国实用内科杂志2011，Vol.31Issue(9)：697-699,3.
高容量血液滤过治疗脓毒症并发多器官功能障碍综合征RIFLE标准应用研究
RIFLE criteria for evaluation of high-volume hemofiltration in treatment of patients with sepsis multiple organ dysfunction syndrome.
摘要
Abstract
Objective To explore the use of RIFLE criteria in evaluation of therapeutic time of high-volume hemofiltration (HVHF) in treatment of sepsis complicated with multiple organ dysfunction syndrome ( MODS) and the effects of HVHF on prognosis. Methods Between January 2006 and September 2010,52 patients with sepsis and MODS undergoing HVHF in Chengdu PLA General Military Hospital were retrospectively analyzed and divided into group A ( AKI I ) , group B ( AKI II ) and group C ( AKI IH ) according to the RIFLE criteria. The mortality rate,mean ICU stay,mean mechanical ventilation time and the mean time of continuous HVHF treatment were compared among three groups. Moreover,indexes such as APACHE II score,sequential organ failure assessment (SOFA) score, serum interleukin-6 (IL-6), oxygenation index, plasma creatinine ( Cr) and mean arterial pressure ( MAP) before and at 24 h after HVHF treatment were also compared. Results (1 ) APACHE II score, SOFA score, plasma IL-6 and the mortality rate in group C were significantly higher than those in groups A and B before HVHF treatment (P<0. 01); (2)There were no significant differences in APACHE H score,SOFA score and the mortality rate in groups A group B before HVHF treatment (P >0. 05) .however,serum IL-6,mean ICU stay, mean mechanical ventilation time and the mean time of continuous HVHF treatment in group B were remarkably higher than those in group A (P < 0. 01);(3)The plasma IL-6,oxygenate index,serum creatinine (Cr) and MAP were improved significantly at 24 h after HVHF treatment. Nevertheless, IL-6 in group C was still higher thanthose in groups A and B, and IL-6 in group B was higher than that in group A (P < 0. 01); APACHE II score and SOFA score were decreased significantly in groups A and B (P < 0. 01), while no change was found in group C (P > 0. 05). Conclusion HVHF can be useful in assisting treatments for sepsis complicated with MODS; RIFLE criteria and IL-6 may help prediction of prognosis; Early HVHF treatment can remarkably improve the prognosis of sepsis complicated with MODS in stages AKI I and H .while the efficacy of HVHF treatment can be better in AKI I stage.关键词
高容量血液滤过/脓毒症/多器官功能障碍综合征/RIFLE标准Key words
high-volume hemofiltration/sepsis/multiple organ dysfunction syndrome/MODS/RIFLE criteria分类
医药卫生引用本文复制引用
丁盛,张渝华,张近宝,欧阳辉,高峰,邬晓臣..高容量血液滤过治疗脓毒症并发多器官功能障碍综合征RIFLE标准应用研究[J].中国实用内科杂志,2011,31(9):697-699,3.基金项目
四川省卫生厅计划项目(编号100190) （编号100190）
四川省卫生厅资助项目(编号100095,100189) （编号100095,100189）
