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目的 探讨连续性静 静脉血液滤过 (CVVH)对创伤后多器官功能障碍综合征 (MODS)病人血清一氧化氮 (NO)与α 肿瘤坏死因子 (TNF α)浓度及近期预后的影响。方法 17例创伤后MODS病人一经确诊即行床边CVVH。CVVH之前和之后 6h取血和超滤液检测NO与TNF α浓度。结果 CVVH干预后6h血清NO浓度峰值与TNF α浓度峰值与CVVH干预之前比较均有显著性统计学意义 ,CVVH干预组住院病死率明显低于对照组 ,滤过液中也能检测到较高浓度的NO和TNF α。结论 CVVH能够有效清除创伤后MODS病人血中过高的NO和TNF α并明显改善近期预后。
Objective To investigate the effects of continuous venous hemofiltration (CVVH) on serum concentration of nitric oxide (NO) and tumor necrosis factor α (TNF α) in patients with post-traumatic multiple organ dysfunction syndrome (MODS) and its prognosis. Methods Seventeen patients with posttraumatic MODS were diagnosed as bedside CVVH. Blood and ultrafiltrate were collected before and after CVVH to measure the concentrations of NO and TNFα. Results After CVVH intervention, the peak value of serum NO and the peak value of TNFα concentration were significantly different from those before CVVH intervention. The in-hospital mortality of CVVH intervention group was significantly lower than that of control group, and the higher concentration of CVVH NO and TNF alpha. Conclusions CVVH can effectively eliminate the excessive levels of NO and TNFα in post-traumatic MODS patients and significantly improve the short-term prognosis.