急性呼吸窘迫综合征的新探索-连续性血液净化技术（CBP）

目的探讨连续性血液净化（CBP）对ARDS治疗机制及临床意义。方法将36例ARDS患者分成常规治疗组与对照组（常规治疗＋CBP组），CBP组（采取CRRT治疗行24h），各18例，对照组在确诊ARDS初期即给予CBP治疗，观察ARDS治疗前后血清中IL-6、IL-8的水平，比较两组患者的呼吸机相关性肺炎（VAP）发生率、ICU病死率、机械通气时间和入住ICU的时间。结果CRRT组IL-6、8水平较治疗前明显下降（P〈0。01），停止CRRT治疗后上述因子均有不同程度的回升，但仍低于治疗前水平。两组患者通气时间、VAP发生率、ICU入住时间有统计学意义，ICU病死率无统计学意义。结论CBP能有效改善ARDS急性期病情，是一种积极有效的干预措施。

New exploration of acute respiratory distress syndrome-continuity blood purification technology (CBP)

Objective To explore continuity blood purification （CBP） on the treatment mechanism and clinical significance of ARDS. Methods 36 ARDS patients divided into conventional treatment group （n = 18） and control group （ n = 18 ） （ conventional treatment ＋ CBP group）, CBP group （ the patients underwent CRRT for 24 hours）. The control group in the early diagnosis of ARDS treated with CBP, plasma cytokine （IL-6,IL-8）were detected with ELISA and compared between two groups,the changes of ventilator-associated pneumonia （VAP） incidence, ICU mortality incidence, duration of mechanical ventilation and ICU admission time were compared between two groups. Results The IL-6, IL-8 level of the CRRT group were significantly lower than which in the before treatment （P 〈0. ）01 ,after stopped the treatment these factors had different degree of rebound, but still lower than that before treatment. Two groups of patients ventilation time, VAP incidence, ICU check-in time were statistically significant, ICU mortality was not statistically. Conclusion CBP can effectively improve the ARDS the acute phase condition, it is a positive and effective intervention measures.