血液净化治疗在PICU的临床应用调查  

Investigation on the clinical application of blood purification in PICU

作　　者：王丽杰[1] 车喜涵 关文贺 杨佳[1] 赵璠[1] 李楠[1] 贺琳晰[1] 王一鸣[1] 许巍[1] 刘春峰[1] Wang Lijie;Che Xihan;Guan Wenhe;Yang Jia;Zhao Fan;Li Nan;He Linxi;Wang Yiming;Xu Wei;Liu Chunfeng(Department of PICU,Sheng]ing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院PICU,沈阳110004

出　　处：《中国小儿急救医学》2018年第10期729-732,740,共5页Chinese Pediatric Emergency Medicine

基　　金：辽宁省中央引导地方科技发展专项项目（2018108001）

摘　　要：目的 调查我院PICU血液净化治疗的应用情况.方法 回顾性分析我院PICU 2010至2017年经血液净化治疗患儿的基本信息、诊断、住院时间、预后、血液净化模式及次数及并发症等.结果 血液净化患儿占同期住院患儿的3.1％.2010至2017年血液净化患儿数增长了370.6％,例次增加了398.3％;连续性静-静脉血液透析滤过（continuous veno-venous hemodiafiltration,CVVHDF）、血浆置换、血液灌流例次分别增加135.2％、6300％和1600％;CVVHDF、血浆置换、血液灌流例次分别占42.8％（492/1151）、33.5％（386/1151）和23.7％（273/1151）.药物及毒物中毒占比最高为28.6％（81/284）,神经系统疾病占20.8％（59/284）,脓毒症合并多脏器功能障碍综合征、消化系统疾病、自身免疫性疾病、肾脏疾病、代谢性疾病分别占18.0％（51/284）、14.4％（41/284）、4.9％（14/284）、4.9％（14/284）和4.2％（12/284）.治愈加好转率为63.8％.并发症包括血栓等.结论 血液净化治疗已成为救治危重患儿的有效方法.我院和国内儿科血液净化技术发展迅速,需进一步规范应用,为救治危重患儿提供更多选择.Objective To investigate the development and application of blood purification in PICU. Methods The demographic data,diagnosis,length of stay,prognosis,patterns and frequency of blood purifi-cation and complications of PICU patients treated with blood purification in our hospital from 2010 to 2017 were retrospectively analyzed. Results The patients with blood purification accounted for 3. 1％ of hospital-ized children in the same period. From 2010 to 2017,the patients and times with blood purification increased by 370. 6％ and 398. 3％ respectively. The times of continuous veno-venous hemodiafiltration（CVVHDF）, plasma exchange and hemoperfusion increased by 135. 2％,6300％ and 1600％ respectively. The frequency of CVVHDF,plasma exchange and hemoperfusion accounted for 42. 8％（492/1151）,33. 5％（386/1151）, and 23. 7％ （273/1151） respectively. Drug and toxic poision accounted for the highest proportion of 28. 6％（81/284）,neurological diseases accounted for 20. 8％（59/284）,sepsis with multiple organ dysfunction syn-drome accounted for 18. 0％（ 51/284 ） , digestive system diseases, autoimmune diseases, renal diseases and metabolic diseases accounted for 14. 4％（ 41/284 ） ,4. 9％（ 14/284 ） ,4. 9％ （ 14/284 ） and 4. 2％（ 12/284 ） respectively. The cure rate was 63. 8％. Complication included thrombus. Conclusion Blood purification has become the preferred modality for the management of critically ill children. Pediatric blood purification tech-niques have developed rapidly in our PICU and domestic pediatric. Further specification is required,so that it may represent the adequate choice for critical ill children.

关 键 词：血液净化 适应证 儿童 重症 

分 类 号：R720.597[医药卫生—急诊医学]