强化液体负平衡对妊娠期高血压疾病并发急性呼吸衰竭的治疗作用

Strengthened Dehydration Therapy for Parturients with Pregnancy-induced Hypertension Syndrome Complicated with Acute Respiratory Failure

目的:探讨强化液体负平衡对妊娠期高血压疾病并发急性呼吸衰竭的产妇行机械通气治疗的影响。方法:回顾性分析我院收治的24例妊娠期高血压疾病剖宫产术后并发急性呼吸衰竭的产妇,采用机械通气、大量补充蛋白、强化脱水、限液等治疗,每日大量液体负平衡;另选14例相似病例为对照组,采用机械通气、补充蛋白、利尿等治疗,比较两组患者的ICU病死率,病情平稳转出ICU时机械通气时间、每日白蛋白用量、液体负平衡量、呋塞米用量、ICU总费用、中心静脉压、心率、氧合指数(PaO2/FiO2)和血浆白蛋白水平。结果:治疗组的病死率小于对照组(P<0.05)。病情平稳转出ICU时:治疗组每日白蛋白用量、液体负平衡量、呋塞米用量均大于对照组(P<0.05);治疗组机械通气时间、ICU住院时间、ICU总费用小于对照组(P<0.05)。结论:强化液体负平衡对于妊娠期高血压疾病并发急性呼吸衰竭行机械通气治疗的产妇能够降低ICU病死率,缩短ICU存活患者机械通气时间、ICU住院时间,降低ICU总费用。

Objective：To explorethe therapeutical effect of strengthened dehydration therapy （fluid negative balance） for parturients with pregnancy - induced hypertension syndrome （PIH） accompanied with acute respiratory failure. Methods：A retrospective study was done on 28 patients admitted to ICU between March 2001 and May 2006 with pregnancy - induced hypertension syndrome （PIH） accompanied with acute respiratory failure. Mechanical ventilation and supplement of protein were used in all cases. Patients were divided into treatment group （24 cases） and control group （14 cases） according to using strengthen dehydration or diuresis only. Results： The fatality rate in treatment group was lower than the control group （P〈0.05）. In treatment group, dosage of albumin, fluid negative balance, and dosage of Furosemide per day exceeded control group （ P〈0.05）. The duration of mechanical ventilation, length of stay and charges in ICU were less than the control group （ P 〈 0.05）. The central vein pressure, heart rate, PaO2/FiO2, and plasma-albumin improved remarkably, when patients depart from ICU.Conclusions： Strengthened dehydration therapy （fluid negative balance） to parturients with Pregnancy- induced Hypertension syndrome （PIH） accompanied with acute respiratory failure can reduce fatality rate with shorten duration of mechanical ventilation, length of stay and less costs in ICU.