连续性血液净化对肺外源ARDS患者肺血管外肺水及呼吸功能的影响

目的观察连续性血液净化（CBP）对肺外源急性呼吸窘迫综合征（ARDSexp）患者肺血管外肺水及氧合功能的影响。方
法回顾性分析广州医科大学附属第二医院重症医学科31例ARDSexp患者的临床资料，根据是否行CBP治疗，为血液净化组
（16例）和对照组（15例）；记录治疗后血管外肺水指数（EVLWI)）、肺毛细血管通透指数（PVPI）及呼吸功能的变化。结果血液
净化组死亡率为12.5%，对照组死亡率为33.3%（P<0.05）；血液净化组EVLWI、PVPI、PaO2/FiO2和呼吸功能改善时间明显早于
对照组，效果也优于对照组（P<0.05）。结论早期应用CBP可改善ARDSexp患者肺血管外肺水及通透指数，改善肺氧合功能和
顺应性，从而改善预后。

Effects of continuous blood purification on extravascular lung water and respiratory function in patients with extrapulmonary acute respiratory distress syndrome

Objective To assess the effects of continuous blood purification (CBP) on extravascular lung water and respiratory
function in patients with extrapulmonary acute respiratory distress syndrome (ARDSexp). Methods The data of 31 patients
with ARDSexp admitted in our department were retrospectively analyzed．Sixteen of the patients received CBP, and the other
15 patients did not (control group). The level of extravascular lung water index (EVLWI), pulmonary vascular permeability
index (PVPI), and respiratory function were measured before and after CPB. Results The mortality rate was significantly lower
in CBP group than in the control group (12.5% vs 33.3%, P<0.05). The patients in CPB group showed markedly earlier and
significantly greater improvements in EVLWI, PVPI, PaO2/FiO, and respiratory function than the control patients (P<0.05).
Conclusion CBP can reduce EVLWI and PVPI, improve pulmonary compliance and oxygenation, and reduce mortality rate in
patients with ARDSexp.