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目的探讨高容量血液滤过(HVHF)联合血液灌流(HP)对恙虫病合并多器官功能衰竭(MOF)的疗效。方法回顾性分析解放军421医院2004～2009年行HVHF联合HP治疗恙虫病合并MOF的24例患者,按治疗转归分死亡组和存活组,对比分析两组的血浆内皮素(ET),并将HVHF联合HP治疗前和治疗24h后的血肌酐(Cr)、尿素氮(BUN)、氧合指数、乳酸、平均动脉压(MAP)、APACHE II评分等结果进行比较。结果 (1)死亡组ET明显高于存活组。(2)两组治疗24h后Cr、BUN、氧合指数、乳酸、MAP均明显改善;存活组APACHE II评分显著降低,死亡组无明显变化。结论 HVHF联合HP可有效辅助治疗恙虫病合并MOF;ET对判断恙虫病合并MOF的预后有指导意义。
Objective To investigate the effect of high-volume hemofiltration (HVHF) and hemoperfusion (HP) on scrub typhus combined with multiple organ failure (MOF). Methods A retrospective analysis of PLA Hospital 421 Hospital 2004-2009 line HVHF combined HP treatment of tsutsugamushi disease with MOF in 24 patients, according to the treatment of death and survival groups were divided into treatment group, comparative analysis of plasma endothelin (ET), and The serum creatinine (Cr), blood urea nitrogen (BUN), oxygenation index, lactic acid, mean arterial pressure (MAP) and APACHE II score of HVHF before and 24 h after treatment were compared. Results (1) Death group ET was significantly higher than survival group. (2) Cr, BUN, oxygenation index, lactic acid and MAP in two groups were significantly improved after 24h treatment; APACHE II score in survival group was significantly decreased, while there was no significant change in death group. Conclusions HVHF combined with HP can be an effective adjuvant therapy for scrub typhus associated with MOF. ET may be helpful in judging the prognosis of scrub typhus combined with MOF.