CRRT治疗小儿急性呼吸窘迫综合征临床疗效观察

To observe the clinical curative effect of CRRT treatment of children with acute respiratory distress syndrome

目的:探讨连续性肾脏替代治疗(CRRT)对急性呼吸窘迫综合征(ARDS)患儿的临床疗效。方法:收治PICU的ARDS患儿11例,作为对照组,给予机械通气、抗感染、肾上腺皮质激素、人血白蛋白、速尿利尿及纠正电解质及酸碱平衡治疗。收治PICU的ARDS患儿13例作为试验组,在上述治疗的基础上联合CRRT治疗。比较两组患儿治疗12小时及24小时后氧合指数、呼吸频率的变化,及机械通气时间,入住ICU时间,总住院时间,死亡率。结果:CRRT治疗组对比常规治疗组治疗12小时及24小时后氧合指数、呼吸频率明显改善,各时间点比较差异有统计学意义(P<0.05),机械通气时间、入住ICU时间、总住院天数明显缩短,死亡率下降(P<0.05)。结论:CRRT能有效改善ARDS患儿氧合指数,减轻呼吸窘迫症状,缩短机械通气时间及住院时间,减少死亡率。

Objective:To investigate the clinical efficacy of the continuous renal replacement therapy(CRRT)on acute respiratory distress syndrome(ARDS)in children.Methods:To admit 11 cases of ARDS children in PICU from January 2010 to December 2011, as control group,were treated with mechanical ventilation,anti infection,adrenal cortical hormone,human albumin,furosemide diuresis and correction of electrolyte and acid-base balance treatment.To admit 13 cases of ARDS children in PICU from January 2012 to December 2013,as experimental group,were treated with CRRT in the above the foundation of treatment.12 and 24 hours after treatment,to compare oxygenation index,the change of respiratory frequency,and duration of mechanical ventilation,ICU stay time,hospitalization time,mortality of the two groups.Results:12 and 24 hours after treatment,the oxygenation index,respiratory frequency in CRRT treatment group compared with the conventional treatment group were significantly improved,there was significant difference between each time points(P<0.05).The duration of mechanical ventilation,ICU stay time,hospitalization time were significantly reduced,mortality decreased(P<0.05).Conclusion:CRRT can effectively improve the oxygen index of ARDS patients,alleviate the symptoms of respiratory distress,shorten the duration of mechanical ventilation and hospitalization time,reduce mortality.