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目的探讨应用连续性静脉-静脉血液滤过(CVVH)治疗急性呼吸窘迫综合征(ARDS)的疗效及机制。方法选择2002年5月至2005年11月重庆医科大学附属第一医院急诊ICU住院的76例ARDS患者,在接受常规治疗的同时,行CVVH治疗,每次治疗至少持续24h。CVVH治疗前后监测病情及动脉血气的变化,并测定血中内毒素。结果CVVH治疗后患者气促、发绀等症状明显缓解,低氧血症及酸中毒纠正,急性生理学与慢性健康状况评分(APACHEⅡ)下降。CVVH治疗6h后,血中的内毒素明显下降。结论在用常规治疗方法治疗ARDS的同时行CVVH治疗,有利于低氧血症的纠正和病情的缓解。
Objective To investigate the efficacy and mechanism of continuous veno-venous hemofiltration (CVVH) in the treatment of acute respiratory distress syndrome (ARDS). Methods From May 2002 to November 2005, 76 ARDS patients hospitalized in emergency ICU of First Affiliated Hospital of Chongqing Medical University were treated with CVVH while receiving routine treatment, and each treatment was continued for at least 24h. CVVH before and after treatment to monitor the disease and arterial blood gas changes, and determination of blood endotoxin. Results After CVVH treatment, the symptoms of shortness of breath and cyanosis were relieved. Hypoxemia and acidosis were corrected, and acute physiology and chronic health status score (APACHEⅡ) were decreased. After 6 hours of CVVH treatment, endotoxin in the blood was significantly decreased. Conclusion The treatment of ARDS with conventional treatment at the same time CVVH treatment is conducive to correct the hypoxemia and disease remission.