连续性血液净化对重症肺炎合并心力衰竭患者血气分析及超声心功能指标的改善作用

The effect of continuous blood purification on the index of blood gas anaLysis and echocardiographic function in the patients with severe pneumonia with heart failure

目的探讨连续性血液净化（CBP）对重症肺炎合并心力衰竭患者血气分析及超声心功能指标的改善作用。方法选取我院2015—03-2016-03收治的重症肺炎合并心力衰竭患者86例作为实验研究对象，采用随机法分成实验组与对照组，每组各43例，给予对照组常规治疗，给予实验组CBP治疗，比较分析两组患者血气状况（pH、HCO3-、SaO2、PaO2）及超声心功能指标[二尖瓣口血流速度（SV）、心排出量（CO）、左室射血分数（LVEF）]改善情况。结果两组患者治疗前后所有的血气分析指标水平比较差异有统计学意义（P〈0．05）；实验组患者治疗后HC03-和SaO2水平[（27．04±9．07）mmol／L、（13．96±2．06）％]与对照组[（20．18±5．69）mmol／L、（18．01±3．83）％]比较差异有统计学意义（P〈0．05）。在超声心功能检查指标方面，两组患者治疗前后的各项心功能指标比较差异有统计学意义（P〈0．05），治疗后实验组SV、LVEF[（59．98±11．23）mL/次、（69．94±8．56）％]与对照组[（50．21±9．19）mL／次、（60．18±7．99）％]比较差异有统计学意义（P〈0．05）。结论CBP对重症肺炎合并心力衰竭患者治疗效果显著，有效改善了心功能及血气状况。

Objective To investigate the effect of continuous blood purification（CBP） on the index of blood gas analysis and echocardiographic function in the patients with severe pneumonia with heart failure. Method 86 cases were selected for severe pneumonia patients with heart failure in our hospital from March 2015 to March 2016. 43 cases in each group were randomly divided into experimental group and control group. The control group was given conventional treatment and the experimental group given CBP treatment. The changes of the index of blood gas conditions （pH, HCO3-, SaO2, PaO2） and cardiac function index ：stroke volume （SV）, cardiac output （CO） and left ventricular ejection fraction （LVEF） were compared and analyzed. Result There were differences in blood gas analysis indicators before and after treatment in two groups of patients （P 〈 0.05）. There were significant differences in the levels HCO3- and SaO2 in the experimental group [ （27.04±9.07） mmol/L, （13.96±2.06） % ] after treatment compared with the control group [ （20.18±5.69） mmol/L, （18.01±3.83）% ]. There were significant differences in cardiac function index before and after treatment between the two groups （P 〈 0.05）.After treatment, SV and LVEF of the two groups were different, which were statistically significant [ （59.98± 11.23） mL/time, （69.94± 8.56）% ] vs [ （50.21 ±9.19） mL/time, （60.18 ±7.99）% ] （P 〈 0.05）.Conelusion Continuous blood purification is effective way in the treatment of severe pneumonia complicated with heart failure patients. It can effectively improve the index of cardiac function and blood gas condition. It is worth of applying and spreading.