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连续性血液净化与机械通气联合治疗顽固性心力衰竭合并呼吸衰竭对患者血流动力学及心功能指标的影响 被引量:9

Impacts of continuous renal replacement therapy combined with mechanical ventilation on indices of hemodynamics and cardiac function in patients with refractory heart failure complicated with respiratory failure
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摘要 目的探讨选用连续性血液净化(CRRT)、机械通气联合治疗顽固性心力衰竭合并呼吸衰竭对患者血流动力学及心功能指标的影响。方法选取2017年5月至2020年5月襄阳市中医医院收治的80例顽固性心力衰竭合并呼吸衰竭患者按随机数字表法分为对照组(40例,常规治疗)、观察组(40例,CRRT+机械通气),观察两组患者血流动力学、心功能以及生化指标等。结果治疗后,观察组心率(HR)、平均动脉压(MAP)、血乳酸(Lac)及中心静脉压(CVP)等均显著低于对照组,差异有统计学意义(P<0.05);观察组左室射血分数(LVEF)、左室收缩末内径(LVESd)、左室舒张末内径(LVEDd)及心输出量(CO)等均显著优于对照组,差异有统计学意义(P<0.05);观察组氧合指数(PaO2/FiO2)高于对照组,氨基末端B型脑钠肽前体(NT-pro-BNP)及C反应蛋白(CRP)等均显著低于对照组,差异有统计学意义(P<0.05)。结论顽固性心力衰竭合并呼吸衰竭患者临床治疗中选用CRRT、机械通联合方案,可有效降低患者机体炎症反应,改善患者血流动力学与心功能指标水平,有利于临床治疗效果的提升。 Objective To investigate the impacts of continuous renal replacement therapy(CRRT)combined with mechanical ventilation on indices of hemodynamics and cardiac function in patients with refractory heart failure complicated with respiratory failure.Methods A total of 80 patients with refractory heart failure complicated with respiratory failure admitted to Xiangyang Hospital of Traditional Chinese Medicine from May 2017 to May 2020 were selected,and they were divided into the control group(with conventional treatment,n=40)and the observation group(with CRRT combined with mechanical ventilation,n=40)according to the random number table method.The hemodynamics,cardiac function and biochemical indices in patients of two groups were observed.Results After treatment,the heart rate(HR),mean arterial pressure(MAP),blood lactic acid(Lac)and central venous pressure(CVP)in patients of the observation group were all significantly lower than those of the control group,with statistically significant differences(P<0.05).The left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESd),left ventricular end diastolic diameter(LVEDd)and cardiac output(CO)of patients in the observation group were all significantly superior to those in the control group,with statistically significant differences(P<0.05).The oxygenation index(PaO2/FiO2)in the observation group was higher than that in the control group,while the N-terminal pro brain natriuretic peptide(NT-pro-BNP)and C-reactive protein(CRP)in the observation group were all significantly lower than those in the control group,with statistically significant differences(P<0.05).Conclusion In the clinical treatment of patients with refractory heart failure complicated with respiratory failure,CRRT combined with mechanical ventilation can effectively reduce the inflammatory reaction of patients,improve the index levels of hemodynamics and cardiac function of patients,and is conducive to promoting the clinical therapeutic efficacy.
作者 任万强 李雅彬 REN Wanqiang;LI Yabin(Department of Critical Care Medicine,Xiangyang Hospital of Traditional Chinese Medicine,Hubei,Xiangyang 441000,China;Infection Control Office,Xiangyang Hospital of Traditional Chinese Medicine,Hubei,Xiangyang 441000,China)
出处 《中国医药科学》 2021年第11期235-238,共4页 China Medicine And Pharmacy
关键词 心力衰竭 呼吸衰竭 CRRT 机械通气 心功能水平 Heart failure Respiratory failure CRRT Mechanical ventilatio n Cardiac function level
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