中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2011年
1期
13-15
,共3页
解建%杨君%李涛%徐拥庆%姜志明%张明%张众慧
解建%楊君%李濤%徐擁慶%薑誌明%張明%張衆慧
해건%양군%리도%서옹경%강지명%장명%장음혜
血液滤过%多器官功能衰竭%呼吸力学%血流动力学
血液濾過%多器官功能衰竭%呼吸力學%血流動力學
혈액려과%다기관공능쇠갈%호흡역학%혈류동역학
Hemofiltration%Multiple organ failure%Respiratory mechanics%Hemodynamics
目的 探讨高容量血液滤过对多器官功能障碍综合征(MODS)患者呼吸力学和血流动力学的影响.方法 选择各种病因的MODS患者41例,按照信封法随机分为高容量血液滤过(HVHF)组21例和连续性静脉-静脉血液滤过(CVVH)组20例.观察两组治疗前及治疗24 h气道峰压(Ppeak)、肺动态顺应性(Cdyn)、心排血量(CO)、外周循环阻力(SVR)、肺循环阻力(PVR)和血气分析.结果 HVHF组治疗24 h,Ppeak、Cdyn、CO、PVR、SVR、氧合指数分别为(31.32±2.23)cm H2O(1 cm H2O=0.098 kPa)、(26.18±3.54)ml/cm H2O、(6.18±0.91)L/min、(194.95±11.51)dyn·s·cm-5、(1071.55±66.50)dyn·s·cm-5、(220.41±21.41)mm Hg(1 mm Hg=0.133 kPa),与治疗前的(42.00±3.34)cm H2O、(17.91±4.31)ml/cm H2O、(8.68±1.17)L/min、(267.27±16.29)dyn·s·cm-5、(805.32±18.82)dyn·s·cm-5、(119.41±17.10)mm Hg比较,差异均有统计学意义(P＜0.01),且与CVVH组治疗24 h比较差异亦有统计学意义(P＜0.01).结论 HVHF可明显改善MODS患者的呼吸力学和血流动力学指标.
目的 探討高容量血液濾過對多器官功能障礙綜閤徵(MODS)患者呼吸力學和血流動力學的影響.方法 選擇各種病因的MODS患者41例,按照信封法隨機分為高容量血液濾過(HVHF)組21例和連續性靜脈-靜脈血液濾過(CVVH)組20例.觀察兩組治療前及治療24 h氣道峰壓(Ppeak)、肺動態順應性(Cdyn)、心排血量(CO)、外週循環阻力(SVR)、肺循環阻力(PVR)和血氣分析.結果 HVHF組治療24 h,Ppeak、Cdyn、CO、PVR、SVR、氧閤指數分彆為(31.32±2.23)cm H2O(1 cm H2O=0.098 kPa)、(26.18±3.54)ml/cm H2O、(6.18±0.91)L/min、(194.95±11.51)dyn·s·cm-5、(1071.55±66.50)dyn·s·cm-5、(220.41±21.41)mm Hg(1 mm Hg=0.133 kPa),與治療前的(42.00±3.34)cm H2O、(17.91±4.31)ml/cm H2O、(8.68±1.17)L/min、(267.27±16.29)dyn·s·cm-5、(805.32±18.82)dyn·s·cm-5、(119.41±17.10)mm Hg比較,差異均有統計學意義(P＜0.01),且與CVVH組治療24 h比較差異亦有統計學意義(P＜0.01).結論 HVHF可明顯改善MODS患者的呼吸力學和血流動力學指標.
목적 탐토고용량혈액려과대다기관공능장애종합정(MODS)환자호흡역학화혈류동역학적영향.방법 선택각충병인적MODS환자41례,안조신봉법수궤분위고용량혈액려과(HVHF)조21례화련속성정맥-정맥혈액려과(CVVH)조20례.관찰량조치료전급치료24 h기도봉압(Ppeak)、폐동태순응성(Cdyn)、심배혈량(CO)、외주순배조력(SVR)、폐순배조력(PVR)화혈기분석.결과 HVHF조치료24 h,Ppeak、Cdyn、CO、PVR、SVR、양합지수분별위(31.32±2.23)cm H2O(1 cm H2O=0.098 kPa)、(26.18±3.54)ml/cm H2O、(6.18±0.91)L/min、(194.95±11.51)dyn·s·cm-5、(1071.55±66.50)dyn·s·cm-5、(220.41±21.41)mm Hg(1 mm Hg=0.133 kPa),여치료전적(42.00±3.34)cm H2O、(17.91±4.31)ml/cm H2O、(8.68±1.17)L/min、(267.27±16.29)dyn·s·cm-5、(805.32±18.82)dyn·s·cm-5、(119.41±17.10)mm Hg비교,차이균유통계학의의(P＜0.01),차여CVVH조치료24 h비교차이역유통계학의의(P＜0.01).결론 HVHF가명현개선MODS환자적호흡역학화혈류동역학지표.
Objective To investigate the effect of continuous high volume hemofiltration (HVHF)on respiratory mechanics and hemodynamics in multiple organ dysfunction syndrome (MODS). MethodsForty-one adult patients with MODS who received mechanical ventilation were divided into HVHF group(21 cases) and continuous vein-vein hemofiltration (CVVH) group (20 cases) by envelople. The peak airway pressure (Ppeak), dynamic pulmonary compliance(Cdyn), cardiac output(CO ), systemic vascular resistance(SVR), pulmonary vascular resistance (PVR) and blood gas analysis before treatment and 24 hours after treatment were measured. Results Twenty-four hours after treatment, the levels of Ppeak, Cdyn, CO, PVR,SVR and oxygenation index were (31.32 ±2.23) cm H2O (1 cm H2O =0.098 kPa), (26.18 ±3.54)(220.41 ±21.41) mm Hg (1 mm Hg =0.133 kPa) respectively in HVHF group,significantly higher than those before treatment [(42.00 ±3.34) cm H2O, (17.91 ±4.31) ml/cm H2O, (8.68 ±1.17) L/min,(267.27 ± 16.29) dyn·s·cm-5, (805.32 ± 18.82)dyn ·s·cm-5, ( 119.41 ± 17.10) mm Hg] (P ＜ 0.01 ),as well as higher than those in CVVH group after 24 hours' treatment (P ＜ 0.01 ). Conclusion HVHF shows significant beneficial effects on respiratory mechanics and hemodynamics of MODS.
