Clinical investigation of high volume hemofiltration combined with plasma exchange in rhabdomyolysis com-bined with multiple organ dysfunction syndrome

WU Ji; ZHAO Jing-yu; WANG Nai-ping

doi:10.3969/j.issn.1674-3806.2015.06.13

Abstract：Objective To investigate the clinical therapy of high volume hemofiltration(HVHF) combined with plasma exchange( PE) in patients with rhabdomyolysis( RM) combined with multiple organ dysfunction syndrome ( MODS) .Methods Twenty patients with RM combined with MODS were enrolled from January 2010 to September 2014 in our hospital and were randomly divided into two groups:HVHF group(n=10) and HVHF combined with PE group(n=10).The changes of the vital signs, APACHEⅡscore, serum creatinine, blood urea nitrogen,lactate de-hydrogenase, creatine kinase, alanine aminotransferase, aspartate aminotransferase, myoglobin, tumor necrosis fac-tor-α, interleukin-1 and interleukin-6 levels were compared between the two groups after the treatments for 5 days. Results The vital signs were more stable in both of the two groups after 5 days of the treatment compared with pre-treatment.APACHE Ⅱscore, serum creatinine, blood urea nitrogen, lactate dehydrogenase, creatine kinase, ala-nine aminotransferase, aspartate aminotransferase, myoglobin, tumor necrosis factor-α, interleukin-1 and interleukin-6 levels were significantly declined in both of the two groups after the treatments for 5 days (P<0.05).Myoglobin was significantly reduced in HVHF combined with PE group than that in HVHF group( P<0.01) .The levels of ser-um creatinine, blood urea nitrogen, lactate dehydrogenase, creatine kinase, alanine aminotransferase, aspartate ami-notransferase, tumor necrosis factor-α, interleukin-1 and interleukin-6 were not significantly different between the two groups(P>0.05).Conclusion The inflammatory factors and myoglobin are effectively eliminated in patients with RM combined with MODS by both HVHF and PE, which improve the clinical symtoms and prognosis of the patients. PE is obviously better than hemofiltration( HF) to remove myoglobin filter coefficients.HVHF combined with PE is the preferent method for treating RM combined with MODS.