论文部分内容阅读
目的探讨连续性血液净化(CBP)治疗急性呼吸窘迫综合征(ARDS)伴低氧血症的临床效果。方法本院2005年3月—2014年3月共收治ARDS伴低氧血症患者79例,采用随机分层分组法将79例患者分为2组,对照组给予常规综合治疗措施,观察组在综合治疗基础上给予CBP疗法,观察2组治疗前后血流动力学参数、血氧饱和度(Sa O2)、氧合指数(Pa O2/Fi O2)、静态肺顺应性、气道阻力及实验室检测指标。结果 2组心率(HR)及心脏指数(CI)差异无统计学意义(P>0.05),而观察组心输出量(CO)、肺动脉压(PAP)、Sa O2及平均动脉压(MAP)明显优于对照组,2组差异有统计学意义(P<0.05)。治疗48 h后2组Pa O2/Fi O2、静态肺顺应性及气道阻力均优于治疗前(P<0.05),而2组间静态肺顺应性及气道阻力差异无统计学意义(P>0.05。观察组治疗后肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)及血乳酸水平均低于对照组,2组差异有统计学意义(P<0.05)。结论CBP疗法能显著改善ARDS伴低血氧症患者的心输出量、血氧饱和度及Pa O2/Fi O2,降低血清炎性因子水平,改善呼吸力学和脏器功能,快速缓解ARDS患者缺氧症状,有利于患者早期康复。
Objective To investigate the clinical effect of continuous blood purification (CBP) on acute respiratory distress syndrome (ARDS) with hypoxemia. Methods A total of 79 ARDS patients with hypoxemia were admitted to our hospital from March 2005 to March 2014. 79 patients were divided into two groups by random stratified grouping method and the control group were given conventional comprehensive treatment. CBP therapy was given on the basis of comprehensive treatment, and the hemodynamic parameters, Sa O2, Pa O2 / Fi O2, static lung compliance, airway resistance and laboratory before and after treatment were observed Detection Indicator. Results There were no significant differences in heart rate (HR) and cardiac index (CI) between the two groups (P> 0.05), while the levels of cardiac output (CO), pulmonary arterial pressure (PAP), Sa O2 and mean arterial pressure The difference between the two groups was statistically significant (P <0.05). PaO2 / Fi O2, static lung compliance and airway resistance in both groups were better than those before treatment (P <0.05) at 48 hours after treatment, but there was no significant difference in static lung compliance and airway resistance between the two groups (P > 0.05.The levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and blood lactate in the observation group after treatment were lower than those in the control group, with significant difference between the two groups (P0.05) Can significantly improve ARDS hypoxemia in patients with cardiac output, oxygen saturation and Pa O2 / Fi O2, lower serum levels of inflammatory cytokines, improve respiratory mechanics and organ function, rapid relief of ARDS patients with hypoxia symptoms, there Benefit from early recovery of patients.