| 雷智贤,周莉蓉,王 琪,麦碧薇,朱乃云.不同剂量置换液连续血液净化对ARDS患儿呼吸系统指标、细胞炎性因子和不良事件的影响[J].,2020,(7):1377-1380 |
| 不同剂量置换液连续血液净化对ARDS患儿呼吸系统指标、细胞炎性因子和不良事件的影响 |
| Effects of Continuous Blood Purification with Different Doses of Replacement Fluid on Respiratory System Indexes, Cytokines and Adverse Events in Children with ARDS |
| 投稿时间：2019-10-23 修订日期：2019-11-18 |
| DOI：10.13241/j.cnki.pmb.2020.07.039 |
| 中文关键词: 剂量 置换液 连续血液净化 儿童 急性呼吸窘迫综合征 呼吸系统 炎性因子 不良事件 |
| 英文关键词: Doses Replacement fluid Continuous blood purification Children Acute respiratory distress syndrome Respiratory system Cytokines Adverse events |
| 基金项目:海南省自然科学基金项目（813245） |
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| 中文摘要: |
| 摘要 目的：探讨不同剂量置换液连续血液净化（CBP）对小儿急性呼吸窘迫综合征（ARDS）呼吸系统指标、细胞炎性因子和不良事件的影响。方法：选取2016年3月~2019年3月期间我院收治的ARDS患儿117例，根据随机数字表法将患儿分为常规剂量组（n=58，常规剂量置换液治疗）和高剂量组（n=59，高剂量置换液治疗），比较两组患儿治疗效果、呼吸系统指标、细胞因子、小儿危重病例评分(PCIS)、第三代小儿死亡风险(PRISMⅢ)评分和不良事件发生情况。结果：两组患儿好转率比较无差异（P>0.05）。两组患儿治疗终点时动脉血氧分压、氧合指数、白介素-10（IL-10）水平、PCIS较治疗前升高，且高剂量组高于常规剂量组（P<0.05）；动脉二氧化碳分压、白介素-1β（IL-1β）水平、肿瘤坏死因子-α（TNF-α）水平、PRISMⅢ评分较治疗前降低（P<0.05），且高剂量组动脉二氧化碳分压、IL-1β、TNF-α水平低于常规剂量组（P<0.05），但两组治疗终点时PRISMⅢ评分比较无差异（P>0.05）。两组不良事件发生率比较差异无统计学意义（P>0.05）。结论：常规剂量和高剂量置换液CBP均可有效改善ARDS患儿呼吸系统指标、细胞炎性因子，且高剂量置换液CBP对上述指标的改善效果更优，但在好转率、PRISMⅢ评分等方面无明显优势。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of continuous blood purification (CBP) with different doses of replacement fluid on respiratory system indexes, cytokines and adverse events in children with acute respiratory distress syndrome (ARDS). Methods: 117 cases of ARDS who were admitted to our hospital from March 2016 to March 2019 were selected. According to the random number table, the patients were divided into the conventional dose group (n=58, conventional dose replacement fluid) and the high dose group (n=59, high dose replacement fluid). The therapeutic effect, respiratory system index, cytokines, pediatric critical illness score (PCIs) and pediatric risk of mortalityⅢ(PRISMⅢ) scores and adverse events were compared between the two groups. Results: There was no significant difference between the two groups(P>0.05). At the end of treatment, arterial partial oxygen pressure, oxygenation index, interleukin-10(IL-10) level and PCIS in the two groups were higher than before treatment, and those in the high dose group were higher than those in the conventional dose group (P<0.05). Artery partial pressure of carbon dioxide partial pressure, interleukin-1β(IL-1β) levels, tumor necrosis factor-α(TNF-α) levels, the PRISM Ⅲ score were lower than those before treatment(P<0.05), and the arterial partial pressure of carbon dioxide partial pressure, IL-1β, TNF-α levels in the high dose group were lower than those in the conventional dose group (P<0.05). But when two groups at the end of treatment the PRISM Ⅲ score was no difference(P>0.05). There was no significant difference in the incidence of adverse events between the two groups(P>0.05). Conclusion: Conventional dose and high dose CBP displacement fluid can effectively improve ARDS in children with respiratory index, inflammatory cell factor, and high dose displacement fluid CBP better improve the effect of the above indicators, but in the recovery, PRISM Ⅲ score has no obvious advantage, etc. |
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