早期应用高容量血液滤过治疗急性呼吸窘迫综合征的效果  

Effect of early application of high volume hemofiltration in the treatment of acute respiratory distress syndrome

作　　者：蒋勇[1] 肖仁威 缪碧丽 文勇[1] 梁德坚[1] 曾佑强 邓光进 JIANG Yong;XIAO Ren-wei;MIAO Bi-li;WEN Yong;LIANG De-jian;ZENG You-qiang;DENG Guang-jin(Department of Critical Care Medicine,People′s Hospital of Yingde City in Guangdong Province,Yingde513000,China)

机构地区：[1]广东省英德市人民医院重症医学科,广东英德513000

出　　处：《中国当代医药》2018年第34期29-31,共3页China Modern Medicine

基　　金：广东省清远市科技计划项目(170809121901281)

摘　　要：目的探讨早期应用高容量血液滤过(HVHF)治疗急性呼吸窘迫综合征(ARDS)的效果。方法选取我院2017年6月～2018年6月收治的32例ARDS患者作为研究对象,采用HVHF在早期开始治疗,比较患者治疗前及治疗12、24、48、72 h后的APACHEⅡ评分、气道峰压、肺顺应性、PaO_2、氧合指数(PaO_2/FiO_2)、乳酸的变化。结果HVHF治疗12、24、48、72 h后,患者的APACHEⅡ评分、气道峰压、乳酸较治疗前显著下降,肺顺应性、PaO_2、PaO_2/FiO_2较治疗前显著升高,差异均有统计学意义(P<0.05)。结论应用HVHF早期开始治疗ARDS,能降低患者危重程度,使患者气道峰压下降,肺顺应性升高,进而改善患者肺通气功能,提高氧分压及氧合指数,改善肺换气功能,使血乳酸下降,组织器官功能缺氧状态改善。Objective To investigate the effect of high volume hemofiltration(HVHF)in the early treatment of acute respiratory distress syndrome(ARDS).Methods A total of 32 patients with ARDS admitted to our hospital from June 2017 to June 2018 were selected as subjects.HVHF was used in the early stage.The changes of APACHEⅡscore,peak airway pressure,lung compliance,PaO2,PaO2/FiO2 and lactic acid were compared before and after 12,24,48 h and 72 h of treatment.Results APACHEⅡscore,peak airway pressure and lactate ratio were significantly decreased at 12,24,48 h and 72 h after treatment with HVHF,lung compliance,PaO2,PaO2/FiO2 were significantly higher than those before treatment(P<0.05).Conclusion Early treatment with HVHF can reduce the severity of ARDS,decrease the peak airway pressure,increase lung compliance,improve the pulmonary ventilation function,increase oxygen partial pressure and oxygenation index,improve the lung ventilation function,decrease blood lactic acid and improve the hypoxic state of tissue and organ function.

关 键 词：高容量血液滤过 急性呼吸窘迫综合征 肺顺应性 

分 类 号：R563.8[医药卫生—呼吸系统]