CAJ | 학술논문

目的探讨连续血液透析滤过(CVVHDF)对急性呼吸窘迫综合征(ARDS)患儿氧合、血流动力学以及凝血功能的影响.方法 2004年1月至2007年11月复旦大学附属儿科医院收治的11例ARDS患儿为研究对象.所有患儿接受机械通气等治疗,同时行CVVHDF,于治疗前(0 h),治疗后2 h(2 h)、4 h(4 h)、6 h(6 h)记录患儿心率(HR)、平均动脉压(MAP),采血测动脉血气;于治疗前(0 h),治疗后2 h(2 h)、6 h(6 h)采血行血小板计数、D-二聚体和血浆纤维蛋白原检测.各指标各时点间比较采用Stata7.0软件行数据统计分析.结果所有患儿于CVVHDF前均存在氧合指数低、低血压、心率偏快,D-二聚体增高.经CVVHDF治疗后,患儿心率、血压、氧合指数好转,各时点间比较差异有显著性(P＜0.05).治疗中患儿血小板计数进行性下降,D-二聚体降低,各时点间比较差异有显著性(P＜0.05).结论 CVVHDF能有效改善ARDS患儿氧合和稳定血流动力学;对凝血功能无显著不利影响.
목적 탐토련속혈액투석려과(CVVHDF)대급성호흡군박종합정(ARDS)환인양합、혈류동역학이급응혈공능적영향.방법 2004년1월지2007년11월복단대학부속인과의원수치적11례ARDS환인위연구대상.소유환인접수궤계통기등치료,동시행CVVHDF,우치료전(0 h),치료후2 h(2 h)、4 h(4 h)、6 h(6 h)기록환인심솔(HR)、평균동맥압(MAP),채혈측동맥혈기;우치료전(0 h),치료후2 h(2 h)、6 h(6 h)채혈행혈소판계수、D-이취체화혈장섬유단백원검측.각지표각시점간비교채용Stata7.0연건행수거통계분석.결과 소유환인우CVVHDF전균존재양합지수저、저혈압、심솔편쾌,D-이취체증고.경CVVHDF치료후,환인심솔、혈압、양합지수호전,각시점간비교차이유현저성(P＜0.05).치료중환인혈소판계수진행성하강,D-이취체강저,각시점간비교차이유현저성(P＜0.05).결론 CVVHDF능유효개선ARDS환인양합화은정혈류동역학;대응혈공능무현저불리영향.
Objective To investigate the effect of CVVHDF on children with acute respiratory distress syndrome(ARDS).Methods Eleven patients with ARDS from Jan 2004 to Dec 2007 admitted to Children's Hospital of Fudan University underwent CWHDF.Before CVVHDF(0 h) and two hours(2 h)、four hours (4 h) and six hours(6 h) after CVVHDF,we recorded the HR、MAP and detected blood gas together with the blood platelet count、D-dimer and fibrinogen.Results Eleven patients with ARDS presented with low PaO2/FiO2、low MAP and fast heart rate,the D-dimer values were higher than that of before CVVHDF.After receiving the treatment of CWHDF,their HR、MABP、P/F and D-dimer value improved gradually at 2 h、4 h and 6 h.Conclusion CVVHDF has an effect on improving the oxygenation and the hemodynamics of the patients.It has,however,no side effect on the coagulation of the children with ARDS.