羟乙基淀粉和白蛋白扩容治疗对重度子痫前期并发毛细血管渗漏综合征肺功能的影响

Effect of hydroxyethyl starch or albumin on lung function of severe preeclampsia combined with capillary leak syndrome

目的:通过脉搏指示剂连续心排量(PICCO)监护仪和血气分析,观察6%羟乙基淀粉(万汶)和5%白蛋白扩容治疗后对重度子痫前期并发毛细血管渗漏综合征(CLS)患者肺功能的影响。方法:选取62例重度子痫前期并发CLS产后患者,随机分为万汶组(30例)和白蛋白组(32例),采用PICCO监护仪,在扩容前、在扩容后8、16、24h记录血管外肺水指数(EVLWI)、取动脉血测定血气、计算氧合指数和肺泡动脉氧分压差(P(A-a)O2)及呼吸指数(RI)。结果:万汶组扩容后8、16、24h不同时间点EVLWI、P(A-a)O2和呼吸指数显著低于治疗前(P<0.05),万汶组扩容后氧合指数明显高于扩容前(P<0.05)。白蛋白组扩容后8、16、24hEVLWI、P(A-a)O2和呼吸指数显著高于万汶组(P<0.05);白蛋白组氧合指数明显低于万汶组(P<0.05)。结论:万汶扩容治疗不影响重度子痫前期并发CLS的肺功能,与其治疗毛细血管渗漏综合征有关。

Objective：To observe the effect of 6%hydroxyethyl starch（Voluven）or 5%albumin on lung function in severe preeclampsia combined with capillary leak syndrome.Method：Sixty two postpartum patients undergoing volume expansion were divided randomly into two groups：group voluven（30cases）and group albumin（32cases）.Extra-vascular lung water index（EVLWI）and the blood gas was carried on at the same time,respiratory index（RI）and P（A-a）O2were calculated in the two groups at 8,16and 24hours after volume expansion.Result：Compared with group voluven,the extra vascular lung water index（EVLWI）,P（A-a）O2and repiratory index（RI）of group albumin was obviously increased（P〈0.05）.The oxygenation index of group albumin was significately lower than that of group voluven（P〈0.05）.Conclusion：Voluven can improve lung function after volume expansion,which is related to capillary leak syndrome（CLS）.