连续性高容量血液滤过治疗重症急性呼吸窘迫综合征的效果

目的观察连续性高容量血液滤过（CHVHF）治疗重症急性呼吸窘迫综合征（ARDS）的治疗效果。方法选取广东省高要市人民医院2006年3月～2013年5月收治的83例重症ARDS患者,均行连续性高容量血液滤过对治疗,对患者的临床资料进行回顾性分析。结果 83例行CHVHF治疗的重症ARDS患者,机械通气时间3～15d,平均（4.9±3.7）d;患者呼吸窘迫症状有效改善,双肺湿啰音显著下降,氧合功能显著提高,胸部X线检测示斑片状阴影逐步消除;死亡11例,死亡率13.3%。观察83例患者治疗3、6、12h动脉血氧分压（PaO2）、动脉血二氧化碳分压（PaCO2）、吸入气氧浓度与动脉血氧饱和度比值（PaO2/FiO2）,治疗前后比较差异有统计学意义（P〈0.05）。结论连续性高容量血液滤过治疗重症ARDS,具有改善患者肺功能、降低机械通气时长、提高机械通气撤机成功率等优点,积极促进患者治疗恢复。

Objective To discuss the effect of continuity of the high-volume hem filtration （CHVHF） in treatment of acute respiratory distress syndrome （ARDS）. Methods 83 cases of severe ARDS were selected in the hospital from March 2006 to May 2013, and underwent continuous high-volume hem filtration on treatment, clinical data were A retrospective analysis. Results Mechanical ventilation time of 83 severe ARDS patients treated with routine CHVHF treatment was 3-15 d, the average was （4.9 ± 3.7） d;patients with respiratory distress symptoms improve significantly decreased lung auscultation, significantly improved oxygenation , chest X-ray detector showed patchy shadows gradual elimination;11 cases died , the mortality rate was 13.3%. Arterial oxygen pressure （PaO 2）, arterial carbon dioxide partial pressure （PaCO 2）, inhaled oxygen concentration and arterial oxygen saturation ratio （PaO 2/FiO 2） 3 h, treatment 6 h, 12 h treatment of, pre-treatment had significant different compared with before treatment （P〈0.05）. Conclusion CHVHF in treatment of severe ARDS can improve pulmonary function, reduce the time of mechanical ventilation, improve the success rate of weaning from mechanical ventilation , etc, and actively promote the patients recover.