【摘要】 目的 探讨连续静脉-静脉血液滤过联合血浆置换对多脏器功能障碍综合征(MODS)患者血流动力学及氧代谢的影响。方法 选择MODS患者21例，应用连续静脉-静脉血液滤过(CVVH)联合血浆置换进行治疗，治疗期间用Swant-Ganz漂浮导管监测血流动力学变化和氧代谢指标。结果 与血液净化(CBP)前比较，CBP治疗后，体血管阻力指数(SVRI)明显改善，平均动脉压(MAP)回升，心率(HR)下降，肺动脉压及肺动脉楔压(PAP、PCWP)也明显降低，动脉血氧分压明显上升(P<0.01)，氧供及氧耗均有所增加(P<0.05)，动脉血乳酸含量明显降低(P<0.01)，混合静脉血氧分压、静脉血氧饱和度及氧摄取率无明显变化(P>0.05)。结论 CBP可改善MODS患者的全身血流动力学状况，提高患者的氧供，但对氧摄取率无明显影响。

    关键词 连续静脉-静脉血液滤过 血浆置换 多脏器功能障碍综合征 血流动力学 氧代谢

    Effects of continuous veno-venous hemofiltration combined with plasma exchange on

    hemodynamics and oxygenation in patients with multiple organ dysfunction syndrome

    Xie Gang，Jiang Chonghui，Zhou Zaisheng，et al.

    Emergency Department People’s Hospital of Zhongshan City，Zhongshan528400.

    【Abstract】 Objective To evaluate the effects of continuous veno-venous hemofiltration combined with plasˉma exchange on hemodynamics and oxygenation in patients with multiple organ dysfunction syndrome.Methods 21patients with MODS were selected and treated with CVVH combined with PE.Hemodynamics and oxygenation were measured or calculated at scheduled intervals by use of Swan-Ganz catheters.Results Indices of systemic vascular resistance(SVRI) ......