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本文引用的文献

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Adenovirus pneumonia treated with Cidofovir in an immunocompetent high school senior.用西多福韦治疗一名免疫功能正常的高三学生的腺病毒肺炎。
Respir Med Case Rep. 2019 Jan 17;26:215-218. doi: 10.1016/j.rmcr.2019.01.015. eCollection 2019.
2
Human adenovirus type 7 infection causes a more severe disease than type 3.人腺病毒 7 型感染比 3 型引起更严重的疾病。
BMC Infect Dis. 2019 Jan 9;19(1):36. doi: 10.1186/s12879-018-3651-2.
3
Factors affecting mortality in children requiring continuous renal replacement therapy in pediatric intensive care unit.影响儿科重症监护病房需要持续肾脏替代治疗的儿童死亡率的因素。
Adv Clin Exp Med. 2019 May;28(5):615-623. doi: 10.17219/acem/81051.
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[Clinical application of the electric cardiometry based non-invasive ICON® hemodynamic monitor].基于心电图的无创 ICON® 血流动力学监测仪的临床应用
Orv Hetil. 2018 Nov;159(44):1775-1781. doi: 10.1556/650.2018.31225.
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Cytokine Clearances in Critically Ill Patients on Continuous Renal Replacement Therapy.危重症患者行连续性肾脏替代治疗时细胞因子的清除。
Blood Purif. 2018;46(4):315-322. doi: 10.1159/000492025. Epub 2018 Aug 14.
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Association Between Fluid Balance and Outcomes in Critically Ill Children: A Systematic Review and Meta-analysis.液体平衡与危重症儿童结局的关系:系统评价和荟萃分析。
JAMA Pediatr. 2018 Mar 1;172(3):257-268. doi: 10.1001/jamapediatrics.2017.4540.
7
Species differences in circulation and inflammatory responses in children with common respiratory adenovirus infections.儿童常见呼吸道腺病毒感染时循环和炎症反应的种属差异。
J Med Virol. 2018 May;90(5):873-880. doi: 10.1002/jmv.25032. Epub 2018 Feb 7.
8
American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock.美国危重病医学会儿童及新生儿感染性休克血流动力学支持临床实践参数
Crit Care Med. 2017 Jun;45(6):1061-1093. doi: 10.1097/CCM.0000000000002425.
9
Does stroke volume variation predict fluid responsiveness in children: A systematic review and meta-analysis.每搏输出量变异能否预测儿童的液体反应性:一项系统评价和荟萃分析
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Epidemiology of Viral Pneumonia.病毒性肺炎的流行病学
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血液净化在重症腺病毒肺炎治疗中的临床应用

[Clinical application of blood purification in treatment of severe adenovirus pneumonia].

作者信息

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

机构信息

Emergency Center, Hunan Children's Hospital, Changsha 410007, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2020 Oct;22(10):1109-1113. doi: 10.7499/j.issn.1008-8830.2004067.

DOI:10.7499/j.issn.1008-8830.2004067
PMID:33059809
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7568989/
Abstract

OBJECTIVE

To study the role of blood purification in the treatment of severe adenovirus pneumonia.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

探讨血液净化在重症腺病毒肺炎治疗中的作用。

方法

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)。

结果

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)。

结论

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。