CAJ | 학술논문

目的：观察胆红素吸附联合血浆置换治疗肝肺综合征呼吸衰竭效果，探讨作用机制。方法134例各种原因肝病合并肝肺综合征患者随机分为血液净化组和对照组，测定纤支镜肺灌洗液中胆红素、IL-6浓度，监测两组机械通气( MV)参数变化，血气分析监测氧代谢情况，评估血液净化对肝肺综合征合并呼吸功能衰竭的治疗效果。结果与对照组相比，血液净化组纤支镜肺灌洗胆红素浓度、IL-6浓度( P<0．05)，均明显下降，机械通气脱机时间早，时间短，呼吸机支持力度小(P<0．05)，氧分压升高而肺泡-动脉氧分压差下降(P<0．05)，肺功能明显改善。结论血液净化可有效治疗肝肺综合征改善肺功能，纠正呼吸衰竭，原因与清除肺组织局部胆红素沉积、炎症介质等因索有关。
목적：관찰담홍소흡부연합혈장치환치료간폐종합정호흡쇠갈효과，탐토작용궤제。방법134례각충원인간병합병간폐종합정환자수궤분위혈액정화조화대조조，측정섬지경폐관세액중담홍소、IL-6농도，감측량조궤계통기( MV)삼수변화，혈기분석감측양대사정황，평고혈액정화대간폐종합정합병호흡공능쇠갈적치료효과。결과여대조조상비，혈액정화조섬지경폐관세담홍소농도、IL-6농도( P<0．05)，균명현하강，궤계통기탈궤시간조，시간단，호흡궤지지력도소(P<0．05)，양분압승고이폐포-동맥양분압차하강(P<0．05)，폐공능명현개선。결론혈액정화가유효치료간폐종합정개선폐공능，규정호흡쇠갈，원인여청제폐조직국부담홍소침적、염증개질등인색유관。
Objective To observe the clinical effect of bilirubin adsorption combined with plasma exchange therapy in the treatment of hepatopulmonary syndrome respiratory failure. Methods 134 cases of various cause liver disease combined with hepatopulmonary syndrome patients were randomly divided into the blood purification group and the control group. The concentration of bilirubin and IL-6 in bronchoscopy lung lavage fluid was determined. Me-chanical ventilation ( MV) parameters, oxygen metabolism and blood gas analysis were monitored. Results Com-pared with the control group, the concentration of bilirubin and IL-6 decreased significantly in the blood purification group (P<0. 05). The blood purification group had earlier weaning time of mechanical ventilation, shorter ventila-tion time, and smaller ventilator support than the control group (P<0. 05). The improvement of pulmonary function was more pronounced in the blood purification group than in the control group. Conclusion Blood purification can effectively improve lung function and correct respiratory failure in the treatment of hepatopulmonary syndrome respira-tory failure, which may be related with the clearance of local bilirubin deposition of lung and inflammatory mediators.