脉冲式高容量血液滤过治疗急性呼吸窘迫综合征的临床效果
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摘要
目的探讨脉冲式高容量血液滤过治疗急性呼吸窘迫综合征的临床效果。方法选取2016年2月～2018年3月我院ICU收治的52例急性呼吸窘迫综合征患者,按照随机数字表法分为实验组与对照组,每组各26例。对照组行常规治疗方法+常规剂量血液滤过治疗,实验组行常规治疗方法+脉冲式高容量血液滤过治疗,比较两组患者治疗前后的生命体征以及血气指标动态变化。结果两组治疗后8、24 h的动脉压高于治疗前,且两组治疗后8、24 h的体温、呼吸次数、脉搏低于治疗前,差异有统计学意义(P<0.05)。实验组治疗后8、24 h的动脉压高于对照组,且实验组治疗后8、24 h的体温、呼吸次数、脉搏低于对照组,差异有统计学意义(P<0.05)。两组治疗后8、24 h的pH值、氧气指数高于治疗前,差异有统计学意义(P<0.05)。实验组治疗后8 h的氧气指数高于对照组,差异有统计学意义(P<0.05)。结论脉冲式高容量血液滤过治疗急性呼吸窘迫综合征能够有效改善患者生命指征、调节血气指标,值得临床推广应用。
Objective To explore the clinical effect of pulsed high volume hemofiltration in the treatment of acute respiratory distress syndrome.Methods A total of 52 patients with acute respiratory distress syndrome admitted to the ICU of our Hospital from February 2016 to March 2018 were enrolled.The patients were divided into the experimental group and the control group according to the random number table methods,with 26 cases in each group.The control group received conventional treatment plus conventional dose hemofiltration.The experimental group received routine treatment plus pulsed high-volume hemofiltration.The dynamic changes of vital signs and blood gas indexes before and after treatment were compared between the two groups.Results After 8 h and 24 h of treatment,the arterial pressure in the two groups was higher than that before treatment,and body temperature,respiratory rate and pulse rate after 8 h and 24 h of treatment were lower than those before treatment,the difference was statistically significant(P<0.05).The arterial pressure in the experimental group after 8 h and 24 h of treatment was higher than those in the control group,and body temperature,respiratory rate and pulse rate in the experimental group after 8 h and 24 h of treatment were lower than those in the control group,the difference was statistically significant(P<0.05).After 8 h and 24 h of treatment,the pH value and oxygen index in the two groups were higher than those before treatment,with significant difference(P<0.05).The oxygen index in the experimental group after 8 h of treatment was higher than that in the control group,with significant difference(P<0.05).Conclusion In the treatment of acute respiratory distress,pulsed high-volume hemofiltration can help improve the patients′ vital signs and regulate their blood gas index,it is worthy of clinical popularization and application.
Objective To explore the clinical effect of pulsed high volume hemofiltration in the treatment of acute respiratory distress syndrome.Methods A total of 52 patients with acute respiratory distress syndrome admitted to the ICU of our Hospital from February 2016 to March 2018 were enrolled.The patients were divided into the experimental group and the control group according to the random number table methods,with 26 cases in each group.The control group received conventional treatment plus conventional dose hemofiltration.The experimental group received routine treatment plus pulsed high-volume hemofiltration.The dynamic changes of vital signs and blood gas indexes before and after treatment were compared between the two groups.Results After 8 h and 24 h of treatment,the arterial pressure in the two groups was higher than that before treatment,and body temperature,respiratory rate and pulse rate after 8 h and 24 h of treatment were lower than those before treatment,the difference was statistically significant(P<0.05).The arterial pressure in the experimental group after 8 h and 24 h of treatment was higher than those in the control group,and body temperature,respiratory rate and pulse rate in the experimental group after 8 h and 24 h of treatment were lower than those in the control group,the difference was statistically significant(P<0.05).After 8 h and 24 h of treatment,the pH value and oxygen index in the two groups were higher than those before treatment,with significant difference(P<0.05).The oxygen index in the experimental group after 8 h of treatment was higher than that in the control group,with significant difference(P<0.05).Conclusion In the treatment of acute respiratory distress,pulsed high-volume hemofiltration can help improve the patients′ vital signs and regulate their blood gas index,it is worthy of clinical popularization and application.
引文
[1]孙涛,郭安,付会文,等.高容量血液滤过治疗脓毒症引发的重度ARDS的疗效探讨[J].临床肺科杂志,2016,21(5):846-849.
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[9]王向蒙,肖文凯,邓烈华.中性粒细胞来源微颗粒引起大鼠急性呼吸窘迫综合征的病理学变化[J].中国急救医学,2018,38(1):89-93.
[10]唐小卿,王春全,俞丽,等.连续性静脉-静脉血液滤过在治疗急性呼吸窘迫综合征中的应用价值[J].临床肺科杂志,2018,23(5):887-890.
[11]王海芳,王艳,高淑霞,等.不同前后稀释比例在连续性静脉-静脉血液滤过中的临床应用研究[J].现代中西医结合杂志,2017,26(12):1326-1328.
[12]黄惠斌,李莹,陈龙,等.脉冲式高容量血液滤过对老年严重脓毒症患者单核细胞功能的影响[J].中华危重病急救医学,2014,26(4):281-283.
[13]彭俊琼,董文霞,储腊萍,等.脉冲式高容量血液滤过对胃肠肿瘤术后腹腔感染的疗效观察[J].中国血液净化,2014,13(2):93-95.
[14]黄惠斌,刘建琴,陈小莉,等.脉冲式高容量血液滤过治疗脓毒症疗效的Meta分析[J].中国中西医结合急救杂志,2018,25(2):113-119.
[15]孟丽君,刘微丽.不同时机连续性肾脏替代治疗对急性呼吸窘迫综合征的影响[J].中国急救医学,2018,38(1):67-71.
[2]张继承,楚玉峰,曾娟,等.连续性高容量血液滤过治疗重度急性呼吸窘迫综合征的临床疗效[J].中国危重病急救医学,2013,25(3):145-148.
[3]高文英.高容量血液滤过对急性呼吸窘迫综合征患者炎症介质及氧代谢的影响[J].广东医学,2014,35(21):3384-3387.
[4]中华医学会重症医学分会.急性肺损伤/急性呼吸窘迫综合征诊断和治疗指南(2006)[J].中华急诊医学杂志,2007,28(4):19-28.
[5]陈小枫,叶纪录,朱志云,等.脉搏指示连续心排血量监测指导高容量血液滤过治疗急性呼吸窘迫综合征的评价[J].中华危重病急救医学,2014,26(9):650-654.
[6]赵璠,贺琳晰.高频机械通气治疗急性呼吸窘迫综合征患儿的护理体会[J].中国医科大学学报,2016,45(2):167-168.
[7]张志强,马海英,冯宪军,等.重症肺炎合并重度急性呼吸窘迫综合征患者临床特点与预后影响因素分析[J].中华医院感染学杂志,2016,26(6):1297-1299.
[8]孟珊珊,鹿中华,郭凤梅.肝细胞生长因子在急性呼吸窘迫综合征治疗中的研究进展[J].中华内科杂志,2018,57(6):466-468.
[9]王向蒙,肖文凯,邓烈华.中性粒细胞来源微颗粒引起大鼠急性呼吸窘迫综合征的病理学变化[J].中国急救医学,2018,38(1):89-93.
[10]唐小卿,王春全,俞丽,等.连续性静脉-静脉血液滤过在治疗急性呼吸窘迫综合征中的应用价值[J].临床肺科杂志,2018,23(5):887-890.
[11]王海芳,王艳,高淑霞,等.不同前后稀释比例在连续性静脉-静脉血液滤过中的临床应用研究[J].现代中西医结合杂志,2017,26(12):1326-1328.
[12]黄惠斌,李莹,陈龙,等.脉冲式高容量血液滤过对老年严重脓毒症患者单核细胞功能的影响[J].中华危重病急救医学,2014,26(4):281-283.
[13]彭俊琼,董文霞,储腊萍,等.脉冲式高容量血液滤过对胃肠肿瘤术后腹腔感染的疗效观察[J].中国血液净化,2014,13(2):93-95.
[14]黄惠斌,刘建琴,陈小莉,等.脉冲式高容量血液滤过治疗脓毒症疗效的Meta分析[J].中国中西医结合急救杂志,2018,25(2):113-119.
[15]孟丽君,刘微丽.不同时机连续性肾脏替代治疗对急性呼吸窘迫综合征的影响[J].中国急救医学,2018,38(1):67-71.