中国38家医院儿童重症医学科连续血液净化技术应用现况调查  

Surveying the status of continuous blood purification technology application in Chinese pediatric intensive care unit

作　　者：李雷雷[1] 陆国平[1] 

机构地区：[1]复旦大学附属儿科医院重症医学科, 上海201102

出　　处：《中华儿科杂志》2014年第3期201-204,共4页Chinese Journal of Pediatrics

摘　　要：目的 了解连续血液净化（CBP）技术在儿童重症医学科（PICU）的应用现况,为促进CBP技术的发展提供参考依据.方法 2012年3至7月期间,采用调查表形式对国内28个省市代表我国儿童危重症救治水平的40家儿童专科医院或大型综合医院儿科,进行CBP应用现况调查.结果 收到38家医院回复,25家开展CBP技术,最早开展的在1997年,中位数年份为2008年,PICU能独立开展的有21家,18家医院配备专业的护士进行操作、日常维护.CBP实施最多的是连续静脉-静脉血液透析滤过模式,占51.9％.选用普通肝素抗凝的医院有23家,低分子肝素法有2家.选用活化部分凝血活酶时间作为凝血功能检测的医院有21家,由于缺乏设备,选用活化凝血时间作为凝血功能检测的医院仅4家.仅有3家医院可以应用前后稀释联合技术.CBP应用病种最多的仍是肾功能衰竭,占38.1％,其后依次为脓毒症19.1％,药物中毒16.7％.结论 中国PICU的CBP在10年前开始起步,近5年才得到重视和推广,但是相关人员、设备配备不足,抗凝、前后稀释等技术应用不够全面,高容量血液滤过模式应用较少.Objective To learn application status of continuous blood purification （CBP） in pediatric intensive care unit （PICU）,to provide reference to promote the development of CBP technology.Method The survey of CBP application was conducted using questionnaire in 40 hospitals providing intensive care,which included children＆#39;s hospitals and the pediatric sections of general hospitals from 28 provinces/municipalities/autonomous regions in China during March to July of 2012.Result Totally 38 hospital replied,25 hospitals carried out CBP technology,first carried out in 1997,the median year was 2008,21 hospitals＆#39; PICU could independently carry out CBP device,18 hospitals had the nurses who could professionally operate,routinely maintain the device.Continuous veno-venous hemodiafiltration was the largest implementation mode of CBP,accounting for 51.9%.Twenty-three hospitals used ordinary heparin,and 2 hospitals used low molecular weight heparin; 21 hospitals chose activated partial thromboplastin time as the coagulation testing,due to lack of equipment,only four hospitals chose activated clotting time as coagulation testing.Only 3 hospitals could apply before and after dilution joint technology.Kidney failure is still the disease accounting for the highest proportion of diseases requiring CBP application,accounting for 38.1%,followed by sepsis,19.1%,drug poisoning 16.7%.Conclusion CBP started 10 years ago,and got attention and promotion nearly five years ago in China,but the associated personnel,equipment were inadequate,anticoagulation,before and after dilution and other technical applications were not complete enough,high volume hemofiltration mode was seldom used.

关 键 词：重症监护病房 儿科 问卷调查 连续血液净化 

分 类 号：R720.597[医药卫生—急诊医学]