中华神经医学杂志
中華神經醫學雜誌
중화신경의학잡지
CHINESE JOURNAL OF NEUROMEDICINE
2009年
4期
410-412
,共3页
罗炎姣%陈慧%常平%陶少华%王斌
囉炎姣%陳慧%常平%陶少華%王斌
라염교%진혜%상평%도소화%왕빈
连续血液净化%高钠血症%颅脑疾病%儿童
連續血液淨化%高鈉血癥%顱腦疾病%兒童
련속혈액정화%고납혈증%로뇌질병%인동
Continuous blood purification%Hypernatremia%Cerebral disease%Children
目的 探索连续性血液净化(CBP)在儿童颅脑疾病合并高钠血症治疗中的应用价值.方法选择入住我院PICU的9例颅脑疾病合并高钠血症患儿行CBP治疗,根据血清钠水平调整置换液的钠浓度,观察高血钠与病情的关系及实施CBP前后血清钠浓度及纠正速度、血流动力学的变化.结果 9例高钠血症患儿治疗后血清钠均有明显下降,与治疗前比较差异有统计学意义(P<0.05),血清钠每日下降14.2 mmol/L,血钠纠正速度为0.75 mmol/(L·h),治疗过程安全,血流动力学稳定.4例死于多器官功能障碍综合征(MODS),1例放弃治疗,4例治愈出院.结论 CBP 治疗高钠血症效果确切,安全性好,尤其对颅脑疾病合并高钠血症者应尽早实施.
目的 探索連續性血液淨化(CBP)在兒童顱腦疾病閤併高鈉血癥治療中的應用價值.方法選擇入住我院PICU的9例顱腦疾病閤併高鈉血癥患兒行CBP治療,根據血清鈉水平調整置換液的鈉濃度,觀察高血鈉與病情的關繫及實施CBP前後血清鈉濃度及糾正速度、血流動力學的變化.結果 9例高鈉血癥患兒治療後血清鈉均有明顯下降,與治療前比較差異有統計學意義(P<0.05),血清鈉每日下降14.2 mmol/L,血鈉糾正速度為0.75 mmol/(L·h),治療過程安全,血流動力學穩定.4例死于多器官功能障礙綜閤徵(MODS),1例放棄治療,4例治愈齣院.結論 CBP 治療高鈉血癥效果確切,安全性好,尤其對顱腦疾病閤併高鈉血癥者應儘早實施.
목적 탐색련속성혈액정화(CBP)재인동로뇌질병합병고납혈증치료중적응용개치.방법선택입주아원PICU적9례로뇌질병합병고납혈증환인행CBP치료,근거혈청납수평조정치환액적납농도,관찰고혈납여병정적관계급실시CBP전후혈청납농도급규정속도、혈류동역학적변화.결과 9례고납혈증환인치료후혈청납균유명현하강,여치료전비교차이유통계학의의(P<0.05),혈청납매일하강14.2 mmol/L,혈납규정속도위0.75 mmol/(L·h),치료과정안전,혈류동역학은정.4례사우다기관공능장애종합정(MODS),1례방기치료,4례치유출원.결론 CBP 치료고납혈증효과학절,안전성호,우기대로뇌질병합병고납혈증자응진조실시.
Objective To assess the value of continuous blood purification(caP)for treatment of pediatric cerebral disease complicated by hypernatremia. Methods Nine children with cerebral disease and concurrent hypematremia admitted in the pediatric intensive care unit received CBP therapy.The sodium concentration in the exchange fluid was adjusted according to the serum sodium concentration.The correlation between the serum sodium concentration and the disease condition of the children was analyzed,and the changes in sgrum sodium and hemodynamics after CBP were observed.Results Nine children showed significantly decreased sernm sodium after CBP therapy(P<0.05).No significant changes in the hemodynamics wgre observed during CBP in these children(P<0.05),whose disease condition remained stable.The serum sodium Was decreased by 14.2 mmol/L daily,and lowered at the mte of 0.75 mmol/L per hour.Of the 9 children,4 died of multiple organ dysfunction syndrome,1 gave up the treatment,and 4 recovered,with a cure rate of 44.44%. Conclusion As a safe and effective treatment modality for critical patients with hypernatremia,CBP must be carried out as early as possible especially in patients with cerebral disease complicated by hypematremia.