【摘要】：目的:觀察旭化成ACH-10血液凈化機(jī)經(jīng)適當(dāng)改良后能否安全有效地用于低體重兒持續(xù)血液濾過治療。 方法:回顧性分析8例嚴(yán)重多臟器功能衰竭M(jìn)ODS的低體重兒用旭化成ACH-10血液凈化機(jī)改良技術(shù)進(jìn)行持續(xù)靜脈靜脈血液濾過（continuous venous hemofiltration，CVVHF），觀察血鉀、尿素氮、肌酐、乳酸等療效指標(biāo)的變化及血液濾過相關(guān)并發(fā)癥的發(fā)生情況和預(yù)后等。 結(jié)果:8例低體重兒均順利置管，并予常規(guī)方式行血液濾過時(shí)均出現(xiàn)采血不良，無法正常轉(zhuǎn)流；再采用改良技術(shù)，經(jīng)泵前稀釋后均順利轉(zhuǎn)流。治療后嚴(yán)重酸中毒、高鉀血癥、高乳酸血癥等內(nèi)環(huán)境紊亂及腎功能得到明顯改善（P＜0.01）；其中低體溫1例，占12.5%；凈化過程中無明顯血壓下降，但CVVHF治療下機(jī)后出現(xiàn)血壓下降1例，經(jīng)積極處理后改善，，占12.5%；濾柱凝血1例，占12.5%，但濾柱壽命均大于12小時(shí)；無出血等其他并發(fā)癥。 結(jié)論： 1.旭化成ACH-10血液凈化機(jī)經(jīng)適當(dāng)改良后能夠安全有效地用于低體重兒血液濾過，有利于改善嚴(yán)重MODS低體重患兒的重要臟器功能，提高搶救成功率。 2．在特殊情況下，其他血液凈化機(jī)可以借鑒此方法，經(jīng)類似處理，應(yīng)用于低體重兒血液凈化，從而為此類患兒提供搶救時(shí)機(jī)及條件。
[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.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R726.9

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本文編號(hào)：2295126