摘要
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。
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. Mechanical ventilation （MV） parameters, oxygen metabolism and blood gas analysis were monitored. Results Compared 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 ventilation 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 respiratory failure, which may be related with the clearance of local bilirubin deposition of lung and inflammatory mediators.
出处
《临床肺科杂志》
2015年第1期49-52,共4页
Journal of Clinical Pulmonary Medicine
关键词
肝肺综合征
血液净化
临床研究
hepatopulmonary syndrome
blood purification
clinical research
