高容量血液滤过治疗脓毒症引发的重度ARDS的疗效探讨  

Effect of high volume hemofiltration on severe acute respiratory distress syndrome due to sepsis

作　　者：孙涛[1] 郭安[1] 付会文[2] 许运铎 

机构地区：[1]衡水市第二人民医院重症医学科,河北衡水053000 [2]衡水市第二人民医院呼吸内科,河北衡水053000

出　　处：《临床肺科杂志》2016年第5期846-849,共4页Journal of Clinical Pulmonary Medicine

摘　　要：目的 探讨高容量血液滤过（HVHF）治疗由脓毒症引发的重度急性呼吸窘迫综合征（ARDS）的临床疗效。方法 选取2012年8月~2015年3月我院收治的62例脓毒症引发的重度急性呼吸窘迫综合征患者,32例患者接受连续性高容量血液滤过治疗为观察组,30例患者接受常规内科治疗为对照组。观察两组患者治疗前、后（12h、24h、48h）的肺功能指标及血流动力学指标,并对两组患者机械通气时间、住院天数、存活率等进行比较。结果 两组患者治疗前各指标不存在差异（P〉0.05）。治疗后12h、24h、48h时间点,观察组氧合指数、血管外肺水指数、PaCO_2指标均明显优于对照组,差异具有统计学意义（P〈0.05）。治疗后12h、24h、48h时间点,两组心率、平均动脉压指标均有所改善,但差异不具有统计学意义（P〉0.05）。观察组患者维持机械通气的时间及ICU住院时间明显短于对照组,差异具有统计学意义（P〈0.05）,观察组患者1个月存活率明显高于对照组,差异具有统计学意义（P〈0.05）。结论 高容量血液滤过对改善脓毒症引发的重度急性呼吸窘迫综合征患者的肺功能具有明显的效果,并能提供良好的预后。Objective To investigate the effect of high volume hemofihration （HVHF） on severe acute re- spiratory distress syndrome （ARDS） due to sepsis. Methods 62 patients with ARDS due to sepsis were selected in our hospital from August 2012 to March 2015. 32 cases received HVHF as the observation group, and 30 cases re- ceived general treatment as the control group. Their lung function, hemodynamic indexes and prognosis were observed before and after treatment. Results There was no significant difference in all targets between the two groups before treatment （P 〉 O. 05）. The value of OI, EVLWI and PaCO2 in the observation group were better than those in the control group after treatment （ P 〈 0. 05 ）. HR and mean arterial pressure in the two groups improved obviously （ P 〉 0. 05 ）. MV time and LOS in the observation group were less than those in the control group after treatment （ P 〈 0. 05 ）. The 1-month survival rate was higher in the observation group than in the control group after treatment （P 〈 0. 05）. Conclusion HVHF is an effective method and has satisfying prognosis for severe acute respiratory distress syndrome due to sepsis.

关 键 词：高容量血液滤过 脓毒症 急性呼吸窘迫综合征 疗效 

分 类 号：R459.7[医药卫生—急诊医学]