早期间断血液滤过治疗严重胸外伤并创伤性湿肺患者的临床疗效分析  

Early intermittent veno-venous hemofiltration for patients with severe thoracic trauma complicated with traumatic wet lung

作　　者：庞国忠[1] 刘文帅[1] 周玲玲[1] 宋新峰 秦昕东[1] Pang Guozhong;Liu Wenshuai;Zhou Lingling;Song Xinfeng;Qin Xindong(Department of Critical Care Medicine,People′s Hospital of Dezhou City,Dezhou 253014,China;College of Medicine and Nursing,Dezhou University,Dezhou 253023,China)

机构地区：[1]德州市人民医院ICU,253014 [2]德州学院医药与护理学院,253023

出　　处：《国际医药卫生导报》2019年第23期3904-3907,共4页International Medicine and Health Guidance News

摘　　要：目的探讨早期间断血液滤过联合机械通气治疗严重胸外伤并创伤性湿肺患者的临床疗效价值。方法选取2014年10月至2018年9月德州市人民医院ICU收治的严重胸外伤并创伤性湿肺患者33例,分为血滤组(19例)和对照组(14例),血滤组在常规综合治疗基础上进行早期间断血液滤过治疗,对照组接受常规综合治疗。记录两组患者的生命体征、血流动力学参数、氧合指数、血管外肺水指数及APACHEⅡ评分等资料。结果血滤组早期进行血液滤过治疗后患者的血管外肺水指数、APACHEⅡ评分分别为(10.9±3.0)ml/kg、(20.2±3.1)分,均低于对照组的(13.9±5.1)ml/kg、(22.9±4.3)分,差异均有统计学意义(均P<0.05);血滤组机械通气时间、ICU住院时间分别为(9.2±3.1)d、(11.2±6.4)d,均低于对照组的(12.3±4.4)d、(13.6±9.8)d,差异均有统计学意义(均P<0.05)。结论早期间断血液滤过联合机械通气治疗严重胸外伤并创伤性湿肺患者,可以明显改善患者肺功能,缩短机械通气时间,改善患者预后。Objective To investigate the effect of early intermittent veno-venous hemofiltration combined with mechanical ventilation for patients with severe thoracic trauma complicated with traumatic wet lung.Methods A total of 33 patients with severe thoracic trauma complicated with traumatic wet lung admitted to our hospital from October,2014 to July,2018 were selected,and were divided into a hemofiltration group(19 cases)and a control group(14 cases).The control group received conventional comprehensive treatment.On the basis of routine comprehensive treatment,the hemofiltration group received early intermittent veno-venous hemofiltration and mechanical ventilation.The records of these two groups’vital signs,hemodynamic parameters,oxygenation index,APACHEⅡrating,etc.were collected.Results After the treatment,the extravascular lung water index(EVLWI)and APACHEⅡscore were significantly lower in the hemofiltration group than in the control group[(10.9±3.0)ml/kg vs.(13.9±5.1)ml/kg and(20.2±3.1)vs.(22.9±4.3),both P<0.05).The average mechanical ventilation time and the average ICU time were shorter in the hemofiltration group than in the control group[(12.3±4.4)d vs.(9.2±3.1)d and(13.6±9.8)d vs.(11.2±6.4)d,both P<0.05).Conclusion Early intermittent hemofiltration combined with mechanical ventilation could significantly improve the pulmonary function and prognosis and shorten the duration of mechanical ventilation patients with severe thoracic trauma complicated with traumatic wet lung.

关 键 词：间断静脉-静脉血液滤过 严重胸外伤 创伤性湿肺 机械通气 

分 类 号：R655[医药卫生—外科学]