脉冲式高容量血液滤过对急性呼吸窘迫综合征的疗效观察(1)
【摘要】 目的 觀察脉冲式高容量血液滤过对急性呼吸窘迫综合征的疗效。方法 25例符合血液滤过治疗指征的急性呼吸窘迫综合征患者作为观察组， 25例急性呼吸窘迫综合征患者作为对照组。对照组实施常规机械通气治疗， 研究组在机械通气治疗基础上采用脉冲式高容量血液滤过治疗。比较两组患者治疗前后生命体征变化、血气动态变化、机械通气时间、住院时间、呼吸机相关肺炎(VAP)发生率及死亡率。结果 治疗后， 研究组心率(HR)、呼吸频率(RR)及收缩压明显低于对照组， 差异具有统计学意义(P<0.05)；研究组氧分压(PaO2)、氧合指数(PaO2/FiO2)明显高于对照组， 差异具有统计学意义(P<0.05)， 两组患者二氧化碳分压(PaCO2)水平比较差异无统计学意义(P>0.05)；研究组VAP发生率和死亡率分别为8.0%(2/25)、4.0%(1/25)， 对照组分别为32.0%(8/25)、24.0%(6/25)， 研究组VAP发生率和死亡率均低于对照组， 差异具有统计学意义(P<0.05)；研究组住ICU时间及机械通气时间均短于对照组， 差异具有统计学意义(P<0.05)。结论 对急性呼吸窘迫综合征患者给予脉冲式高血容量血液滤过， 可有效改善患者生命体征和血气动态变化， 有助于缩短住ICU时间及机械通气时间， 降低VAP发生率及死亡率， 具有临床应用价值。
【关键词】 脉冲式；高容量血液滤过；急性；呼吸窘迫综合征；疗效
DOI：10.14163/j.cnki.11-5547/r.2017.09.004
Observation of curative effect by pulse high-volume hemofiltration for acute respiratory distress syndrome DENG Xiu-fan. Department of Intensive Medicine， Shaoguan City First People’s Hospital， Shaoguan 512000， China
【Abstract】 Objective To observe curative effect by pulse high-volume hemofiltration for acute respiratory distress syndrome. Methods There were 25 acute respiratory distress syndrome patients meeting hemofiltration indication as observation group， and 25 acute respiratory distress syndrome patients as control group. The control group received conventional mechanical ventilation for treatment， and the research group received additional pulse high-volume hemofiltration to mechanical ventilation for treatment. Comparison was made on changes in vital signs， blood gas dynamic changes， mechanical ventilation time， hospital stay time， incidence of ventilator-associated pneumonia (VAP) and mortality between the two groups before and after treatment. Results After treatment， the research group had obviously lower heart rate (HR)， respiratory rate (RR) and systolic blood pressure than the control group， and their difference had statistical significance (P<0.05). The research group had much higher partial pressure of oxygen (PaO2) and oxygenation index (PaO2/FiO2) than the control group， and the difference had statistical significance (P<0.05). There was no statistically significant difference of partial pressure of carbon dioxide (PaCO2) between the two groups (P>0.05). The research group had incidence of VAP and mortality respectively as 8.0% (2/25) and 4.0% (1/25)， which were respectively 32.0% (8/25) and 24.0% (6/25) in the control group. The research group had all lower incidence of VAP and mortality than the control group， and their difference had statistical significance (P<0.05). The research group had shorter ICU stay time and mechanical ventilation time than the control group， and their difference had statistical significance (P<0.05). Conclusion Implement of pulse high-volume hemofiltration for acute respiratory distress syndrome patients can effectively improve vital signs and blood gas dynamic changes in patients. This method is helpful to shorten ICU stay time and mechanical ventilation time， lower incidence of VAP and mortality. It contains value for clinical application., http://www.100md.com(邓秀凡)
【关键词】 脉冲式；高容量血液滤过；急性；呼吸窘迫综合征；疗效
DOI：10.14163/j.cnki.11-5547/r.2017.09.004
Observation of curative effect by pulse high-volume hemofiltration for acute respiratory distress syndrome DENG Xiu-fan. Department of Intensive Medicine， Shaoguan City First People’s Hospital， Shaoguan 512000， China
【Abstract】 Objective To observe curative effect by pulse high-volume hemofiltration for acute respiratory distress syndrome. Methods There were 25 acute respiratory distress syndrome patients meeting hemofiltration indication as observation group， and 25 acute respiratory distress syndrome patients as control group. The control group received conventional mechanical ventilation for treatment， and the research group received additional pulse high-volume hemofiltration to mechanical ventilation for treatment. Comparison was made on changes in vital signs， blood gas dynamic changes， mechanical ventilation time， hospital stay time， incidence of ventilator-associated pneumonia (VAP) and mortality between the two groups before and after treatment. Results After treatment， the research group had obviously lower heart rate (HR)， respiratory rate (RR) and systolic blood pressure than the control group， and their difference had statistical significance (P<0.05). The research group had much higher partial pressure of oxygen (PaO2) and oxygenation index (PaO2/FiO2) than the control group， and the difference had statistical significance (P<0.05). There was no statistically significant difference of partial pressure of carbon dioxide (PaCO2) between the two groups (P>0.05). The research group had incidence of VAP and mortality respectively as 8.0% (2/25) and 4.0% (1/25)， which were respectively 32.0% (8/25) and 24.0% (6/25) in the control group. The research group had all lower incidence of VAP and mortality than the control group， and their difference had statistical significance (P<0.05). The research group had shorter ICU stay time and mechanical ventilation time than the control group， and their difference had statistical significance (P<0.05). Conclusion Implement of pulse high-volume hemofiltration for acute respiratory distress syndrome patients can effectively improve vital signs and blood gas dynamic changes in patients. This method is helpful to shorten ICU stay time and mechanical ventilation time， lower incidence of VAP and mortality. It contains value for clinical application., http://www.100md.com(邓秀凡)