中国全科医学2012，Vol.15Issue(30)：3476-3480,5.DOI:10.3969/j.issn.1007-9572.2012.10.090
连续性血液净化在小儿急性肺损伤/急性呼吸窘迫综合征治疗中的应用研究
Efficacy of Continuous Blood Purification in Treatment of Acute Lung Injury and Acute Respiratory Distress Syndrome
摘要
Abstract
Objective To investigate the clinical efficacy of Continuous Blood Purification (CBP) in patients with acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) and its influence on prognosis.Methods 60 hypoxemia children admitted to the pediatric intensive care unit of our hospital from April 2010 to June 2012 were divided into ALI group and ARDS group according to PaO2/FiO2 with each group 30 cases.And the two groups were further randomly divided into control 1 group, experiment 1 group, control 2 group and experiment 2 group, with each group 15 cases.The PaO2/FiO2, static lung compliance, airway resistance, liver and kidney function tested by venous blood, myocardial enzyme, TNF-α , CRP and blood lactate were recorded at 0 h, 24 h and 48 h, meanwhile, withdraw time of breathing machine and time to correct hypox-emia were recorded and the mortality rate was calculated.Results The static lung compliance was significantly increased at 48 h in experiment 1 group compared with that in control 1 group (P < 0.05) .In experiment 1 group, the static lung compliance at 48 h was significantly increased compared with that at 0 h and 24 h (P < 0.05) .The PaO2/FiO2 , static lung compliance and airway resistance at 0 h, 24 h and 48 h showed no statistically significant differences between control 2 group and experiment 2 group (P >0.05) .The differences of PaO2/FiO2 , static lung compliance and airway resistance at different time within control 2 group and experiment 2 group showed no statistically significant differences (P >0.05) .The ALT, AST and BUN at 24 h and 48 h between control 1 group and experiment 1 group showed statistically significant differences (P < 0.05) .In control 1 group, the AST at 24 h and 48 h and the BUN at 48 h showed statistically significant differences compared with AST at Oh and BUN at Oh (P < 0.05) .In experiment 1 group, the ALT at 24 h and 48 h, the AST at 24 h and 48 h, the Scr at 24 h and 48 h, the BUN at 24 h and 48 h and the CRP at 48 h showed statistically significant differences compared with the ALT at 0 h, the AST at 0 h, the Scr at 0 h, the BUN at Oh and the CRP at 0 h and 24 h (P <0.05) .The AST at 48 h between control 2 group and experiment 2 group showed statistically significant difference (P < 0.05) .In control 2 group, the differences of CRP showed statistically significant differences between 24 h and 0 h, 48 h and 0h, 48 h and 24 h (P < 0.05) .In experiment 2 group, the AST between 24 h and 0 h, 48 h and 0 h, 48 h and 24 h, the TNF-α bewteen 48 h and 0 h, 24 h, the CRP between 24 h and 0 h, 48 h and 0 h, 48 h and 24 h, the blood lactate between 48 h and 0 h, 24 h all showed statistically significant differences (P <0.05).The withdraw time of breathing machine between ALI group and ARDS group showed statistically significant difference (P < 0.05) .The time to hypoxemia and mortality rate between the two groups showed no statistically significant difference (P > 0.05).Conclusion CBP can improve respiratory mechanics and lung compliance and can shorten withdraw time of breathing machine by reducing inflammatory mediators level and adjusting organ function.Early application of CBP is more effective.关键词
连续性血液净化/急性肺损伤/急性呼吸窘迫综合征Key words
Continuous blood purification/ Acute lung injury/ Acute respiratory distress syndrome分类
医药卫生引用本文复制引用
张英谦,郝京霞,黄波,杨娟,朱孟沙,李丽景,张贵英..连续性血液净化在小儿急性肺损伤/急性呼吸窘迫综合征治疗中的应用研究[J].中国全科医学,2012,15(30):3476-3480,5.基金项目
河北省科技支撑计划项目(10276105D-14) （10276105D-14）
