连续性血液净化治疗急性肺水肿患者的临床效果及安全评价

发布时间：2018-04-17 00:17

本文选题：急性肺水肿 + 连续性血液净化　；参考：《中国医学创新》2017年09期

【摘要】：目的:评价连续性血液净化治疗急性肺水肿的临床效果及安全性。方法:选取2015年9月-2016年10月本院收治的急性肺水肿患者96例,按数字奇偶法将其分为观察组和对照组,各48例。对照组实施常规的药物治疗,观察组在行常规治疗的基础上,对患者行连续性血液净化治疗。记录两组患者加强护理病房(Intensive Care Unit,ICU)的住院时间、总住院时间和平均住院费用,并比较治疗前后两组患者的血氧饱和度、心率、舒张压、收缩压等临床指标及治疗后患者的行呼吸支持率、死亡率。结果:观察组的ICU住院时间为(3.71±1.12)d、总住院时间为(11.10±2.46)d、平均住院费用为(30 143.70±1135.50)元,均明显少于对照组的(7.14±2.10)d、(15.71±3.24)d及(32 120.40±1025.10)元,差异均有统计学意义(P0.05)。治疗前,两组患者的血氧饱和度、心率、舒张压、收缩压比较,差异均无统计学意义(P0.05);治疗后,两组的血氧饱和度均高于治疗前(P0.05),且观察组治疗后明显高于对照组(P0.05);两组的心率、舒张压、收缩压均较治疗前有所降低,且观察组治疗后的心率、舒张压及收缩压均明显优于对照组(P0.05)。治疗后,观察组有5例病情加重需行呼吸机进行呼吸持续治疗,其行呼吸支持率为10.42%(5/48),而对照组有21例需行呼吸持续治疗,其行呼吸支持率为43.75%(21/48),观察组死亡1例,死亡率为2.08%(1/48),而对照组死亡5例,死亡率为10.42%(5/48),观察组的行呼吸支持率和死亡率均明显低于对照组,差异均有统计学意义(P0.05)。结论:针对急性肺水肿患者采取连续性血液净化治疗,有助于缩短患者ICU住院时间,缓解患者临床症状,节省住院费用,降低治疗过程中的行呼吸支持风险以及死亡率,安全可靠,具有较高的临床推广价值。
[Abstract]:Objective: to evaluate the clinical effect and safety of continuous blood purification in the treatment of acute pulmonary edema.Methods: 96 patients with acute pulmonary edema admitted in our hospital from September 2015 to October 2016 were divided into observation group (n = 48) and control group (n = 48).The patients in the control group were treated with routine drug therapy, and the patients in the observation group were treated with continuous blood purification on the basis of routine treatment.The hospitalization time, total hospitalization time and average cost of intensive Care unit in two groups were recorded, and the blood oxygen saturation, heart rate and diastolic blood pressure were compared before and after treatment.Systolic blood pressure and other clinical indicators and patients after treatment respiratory support, mortality.Results: the hospitalization time of ICU in the observation group was 3.71 卤1.12 days, the total hospitalization time was 11.10 卤2.46 days, and the average hospitalization cost was 30 143.70 卤1135.50 yuan, which was significantly lower than that in the control group (15.71 卤3.24 days and 32 120.40 卤1025.10) yuan, respectively. The difference was statistically significant (P 0.05).Before treatment, there was no significant difference in blood oxygen saturation, heart rate, diastolic blood pressure and systolic blood pressure between the two groups.The blood oxygen saturation of the two groups was higher than that of the control group after treatment, and the heart rate, diastolic blood pressure and systolic blood pressure of the two groups were lower than those of the control group, and the heart rate of the observation group after treatment was lower than that of the control group.Diastolic blood pressure and systolic blood pressure were significantly better than that of control group (P 0.05).After treatment, there were 5 patients in the observation group who needed to undergo continuous respiratory therapy with ventilator, and the respiratory support rate was 10.422 / 48, while in the control group, 21 patients needed continuous respiratory therapy, and the respiratory support rate was 43.75% 21 / 48, and one case in the observation group died.The mortality rate was 2.08 / 48, while in the control group, 5 cases died, and the mortality rate was 10.42%. The respiratory approval rate and mortality rate in the observation group were significantly lower than those in the control group (P 0.05).Conclusion: continuous blood purification therapy for patients with acute pulmonary edema can shorten the hospitalization time of patients with ICU, alleviate the clinical symptoms of patients, save the cost of hospitalization, reduce the risk of respiratory support and mortality during the course of treatment.It is safe and reliable and has high clinical value.
【作者单位】：广东省阳江市阳东区人民医院;
【分类号】：R473.5

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