發(fā)布時間：2018-04-17 00:17

  本文選題：急性肺水腫 + 連續(xù)性血液凈化��； 參考：《中國醫(yī)學(xué)創(chuàng)新》2017年09期

【摘要】：目的:評價連續(xù)性血液凈化治療急性肺水腫的臨床效果及安全性。方法:選取2015年9月-2016年10月本院收治的急性肺水腫患者96例,按數(shù)字奇偶法將其分為觀察組和對照組,各48例。對照組實(shí)施常規(guī)的藥物治療,觀察組在行常規(guī)治療的基礎(chǔ)上,對患者行連續(xù)性血液凈化治療。記錄兩組患者加強(qiáng)護(hù)理病房(Intensive Care Unit,ICU)的住院時間、總住院時間和平均住院費(fèi)用,并比較治療前后兩組患者的血氧飽和度、心率、舒張壓、收縮壓等臨床指標(biāo)及治療后患者的行呼吸支持率、死亡率。結(jié)果:觀察組的ICU住院時間為(3.71±1.12)d、總住院時間為(11.10±2.46)d、平均住院費(fèi)用為(30 143.70±1135.50)元,均明顯少于對照組的(7.14±2.10)d、(15.71±3.24)d及(32 120.40±1025.10)元,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療前,兩組患者的血氧飽和度、心率、舒張壓、收縮壓比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05);治療后,兩組的血氧飽和度均高于治療前(P0.05),且觀察組治療后明顯高于對照組(P0.05);兩組的心率、舒張壓、收縮壓均較治療前有所降低,且觀察組治療后的心率、舒張壓及收縮壓均明顯優(yōu)于對照組(P0.05)。治療后,觀察組有5例病情加重需行呼吸機(jī)進(jìn)行呼吸持續(xù)治療,其行呼吸支持率為10.42%(5/48),而對照組有21例需行呼吸持續(xù)治療,其行呼吸支持率為43.75%(21/48),觀察組死亡1例,死亡率為2.08%(1/48),而對照組死亡5例,死亡率為10.42%(5/48),觀察組的行呼吸支持率和死亡率均明顯低于對照組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:針對急性肺水腫患者采取連續(xù)性血液凈化治療,有助于縮短患者ICU住院時間,緩解患者臨床癥狀,節(jié)省住院費(fèi)用,降低治療過程中的行呼吸支持風(fēng)險以及死亡率,安全可靠,具有較高的臨床推廣價值。
[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 鹵1.12 days, the total hospitalization time was 11.10 鹵2.46 days, and the average hospitalization cost was 30 143.70 鹵1135.50 yuan, which was significantly lower than that in the control group (15.71 鹵3.24 days and 32 120.40 鹵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.
【作者單位】： 廣東省陽江市陽東區(qū)人民醫(yī)院;
【分類號】：R473.5

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本文編號：1761214