脉冲式高容量血液滤过在急性呼吸窘迫综合征患者中的应用评价

摘要

目的:探讨脉冲式高容量血液滤过在急性呼吸窘迫综合征(ARDS)患者中应用的安全性以及治疗效果.方法:选取我院ICU 2005年1月～2010年9月收治的ARDS患者22例为研究组(脉冲式高容量血滤组),并回顾性匹配配对寻找26例ARDS患者作为对照组(常规剂量血滤组).比较2种血液滤过方式的安全性及其对患者生命体征、氧合情况、机械通气天数、住ICU天数、28d病死率的影响.结果:脉冲高容量血滤组与常规剂量血滤组在安全性上无显著性差异(P>0.05),但脉冲式高容量组有更高效的改善氧合、稳定血流动力学状态、改善脏器功能的作用.并能够显著缩短住ICU时间和机械通气的天数(均P<0.05).2组患者间28d病死率无显著性差异(P>0.05).结论:脉冲式高容量血液滤过在ARDS患者的治疗中是安全高效的.%Objective:To investigate the clinical effects and safety of pulse high-volume hemofiltration as treatment on patients with acute respiratory distress syndrome (ARDS) in ICU.Methods:This was a retrospective research.Twenty-two patients with ARDS receiving pulse high-volume hemofiltration treatment in the medical ICU from Jan 2005 to Sep 2010 as group B.We also found 26 matching patients as control group(group A) receiving continuous normal-volume hemofiltration.The safety and efficiency of the two treatments were compared. We also compared vital signs,oxygenation index,28-day mortality,the days staying in ICU and the days of ventilation between the two groups. Results:There were no difference in 28-days mortality(19.2％ vs 13.6％,P＞0.05)and the safety indexes (mean arterial pressure,temperatrue,respiration rate and pulse)between the two groups. But we found obvious difference in the days staying in ICU (10.6±4.5 vs 8.1±3.0,P＜0.05)and the days of ventilation(8.6±3.0 vs 6.3±2.5,P＜0.05)of the two groups. Conclusion:It is of great safety and high efficiency to apply pulse high-volume hemofiltration on patients with ARDS in ICU.