白蛋白联合血液净化对毛细血管渗漏综合征患儿的血容量及预充量的影响

Effect of albumin combined with blood purification on blood volume and precharge in children with capillary leakage syndrome

目的探讨白蛋白联合血液净化对毛细血管渗漏综合征患儿血容量/预充量的影响。方法以2014年7月至2017年11月期间,我院收治的59例毛细血管渗漏综合征患儿为研究对象,根据患儿家属意愿及治疗措施随机分为2组,其中以白蛋白联合血液净化治疗的30例为观察组,以常规治疗的29例为对照组,比较两组临床治疗效果、血容量与预充量及CVP、MAP等监测指标的变化。结果观察组患儿全身水肿改善时间及肺水肿改善时间明显短于对照组(P<0.05),观察组死亡率明显低于对照组(P<0.05)。两组治疗后CVP及MAP水平均明显上升,且观察组MAP水平显著高于对照组(P<0.05)。但治疗后两组CVP水平相比差异无统计学意义(P>0.05)。两组患儿经过治疗后血容量及血容量/预充量比值明显上升,且观察组显著高于对照组(P<0.05)。结论白蛋白联合血液净化可有效改善CLS患儿水肿,降低患儿死亡率,有效提高或维持血容量。

Objective To investigate the effect of albumin combined with blood purification on blood volume and precharge in children with capillary leakage syndrome. Methods From July 2014 to July 2017, 59 cases of capillary leakage syndrome in our hospital were studied. According to the different methods of treatment and the wishes of the child s family, 29 cases patient were treated with Routine treatment were considered as the control group, and The study group consisted of 30 patients who received treatment of Albumin combined blood purification. To compare the clinical efficacy, the levels of serum adiponectin and inflammatory factor, and the changes of CVP, MAP and other monitoring indexes in the two groups. Results The improvement time of systemic edema and pulmonary edema in the observation group were significantly shorter than that in the control group （ P 〈0.05）, and the mortality in the observation group was significantly lower than that in the control group （ P 〈0.05）. The level of CVP and MAP increased significantly in the two groups after treatment, and the level of MAP in the study group was significantly higher than that of the control group （ P 〈0.05）. But there was no significant difference in CVP level between the two groups after treatment （ P 〉0.05）. After treatment, the blood volume and the ratio of blood volume / precharge increased significantly in the two groups, and the study group was significantly higher than the control group （ P 〈0.05）. Conclusion Albumin combined with blood purification can effectively improve edema, reduce infant mortality and improve or maintain blood volume in children with capillary leakage syndrome.