Yang Mei-Yu, Zhang Xin-Ping, Cao Jian-She, Zhou Xiong, Cai Zi-Li, Kang Xia-Yan, Xie Bo, Liu Ying, He Jie, Xiao Zheng-Hui
Emergency Center, Hunan Children's Hospital, Changsha 410007, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Oct;22(10):1109-1113. doi: 10.7499/j.issn.1008-8830.2004067.
To study the role of blood purification in the treatment of severe adenovirus pneumonia.
A total of 57 children with severe adenovirus pneumonia who underwent mechanical ventilation from February to June, 2019, were enrolled. According to whether blood purification was performed, they were divided into a purification group with 22 children and a conventional group with 35 children. Related clinical indices were collected, including duration of fever, duration of mechanical ventilation, length of stay in the intensive care unit (ICU), and mortality rate. The purification group was analyzed in terms of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) before blood purification and at 48 hours after blood purification, as well as stroke volume variation (SVV), thoracic fluid content (TFC), arterial partial pressure of oxygen/fraction of inhaled oxygen (P/F) value, and partial pressure of carbon dioxide (PCO) before blood purification and at 6, 12, 24, and 48 hours after blood purification.
Compared with the conventional group, the purification group had significantly shorter duration of fever, duration of mechanical ventilation, and length of stay in the ICU (P<0.05), and there was no significant difference in the mortality rate between the two groups (P>0.05). The purification group had significant reductions in IL-6 and TNF-α after blood purification, (P<0.05) and significant reductions in SVV and TFC at 12, 24, and 48 hours after blood purification (P<0.01), as well as a significant increase in P/F value and a significant reduction in PCO at 6, 12, 24, and 48 hours after blood purification (P<0.01).
Blood purification as an auxiliary therapy can effectively improve the clinical symptoms of children with severe adenovirus pneumonia, and is thus an option for the treatment of severe adenovirus pneumonia in children.
探讨血液净化在重症腺病毒肺炎治疗中的作用。
选取2019年2月至6月期间接受机械通气的57例重症腺病毒肺炎患儿。根据是否进行血液净化,将其分为净化组22例和常规组35例。收集相关临床指标,包括发热持续时间、机械通气时间、重症监护病房(ICU)住院时间及死亡率。分析净化组血液净化前及净化后48小时的白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α),以及血液净化前及净化后6、12、24和48小时的每搏输出量变异度(SVV)、胸腔内液体含量(TFC)、动脉血氧分压/吸入氧分数(P/F)值和二氧化碳分压(PCO₂)。
与常规组相比,净化组的发热持续时间、机械通气时间及ICU住院时间显著缩短(P<0.05),两组死亡率差异无统计学意义(P>0.05)。净化组血液净化后IL-6和TNF-α显著降低(P<0.05),血液净化后12、24和48小时SVV和TFC显著降低(P<0.01),血液净化后6、12、24和48小时P/F值显著升高,PCO₂显著降低(P<0.01)。
血液净化作为辅助治疗可有效改善重症腺病毒肺炎患儿的临床症状,是治疗儿童重症腺病毒肺炎的一种选择。