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目的 评价分子吸附再循环系统 ( MARS)对各种原因导致的多器官功能障碍患者的临床治疗效果。方法 对 6 1例因各种原因导致的多器官功能障碍患者进行了 198次 6～ 2 4 h的 MARS治疗。用序惯性脏器衰竭评分 ( SOFA)方法、生化指标及炎症细胞因子水平等评价疗效。结果 用 MARS治疗后可使患者一氧化氮、肿瘤坏死因子 α、白细胞介素 2、6、8及脂多糖结合蛋白水平均明显下降 ,同时大量水溶性和非水溶性毒素被明显清除 ,患者血流动力学、肝性脑病及呼吸、心、肾功能等临床症状明显改善 ,总体 SOFA评分明显下降 ,总体预后改善 ( 2 5例痊愈出院 ,其中 6例成功接受肝移植 ,总体生存率 4 1.0 % )。结论 MARS可安全有效地用于各种原因导致的多器官功能障碍患者 ,有效清除一氧化氮和炎症细胞因子 ,改善临床预后
Objective To evaluate the clinical effect of molecular adsorption and recirculation system (MARS) on patients with multiple organ dysfunction caused by various causes. Methods A total of 61 patients with multiple organ dysfunction caused by various causes were treated with 198 MARS for 6 ~ 24 h. Efficacy was assessed by sequential assessment of organ failure rate (SOFA), biochemical parameters and levels of inflammatory cytokines. Results The levels of nitric oxide, tumor necrosis factor alpha, interleukin 2, 6, 8 and lipopolysaccharide binding protein in patients with MARS were significantly decreased, while a large number of water-soluble and water-insoluble toxins were significantly eliminated. The clinical symptoms such as hemodynamics, hepatic encephalopathy, respiration, heart and kidney function improved obviously, the overall SOFA score decreased significantly, and the overall prognosis improved (25 cases were discharged, 6 cases received liver transplantation successfully, the overall survival rate was 4 1.0% ). Conclusion MARS can safely and effectively be used in patients with multiple organ dysfunction caused by various causes, effectively removing nitric oxide and inflammatory cytokines, and improving clinical prognosis