机械通气联合CRRT及亚低温复合技术治疗重症手足口病患儿神经源性肺水肿的临床研究

The Clinical Study of the Combined Treatment by Mechanical Ventilation Jointing Systemic Hypothermia and CRRT for Neurogenic Pulmonary Edema with Severe Hand, Foot and Mouth Disease in Children

摘要: 目的：探讨全身亚低温及CRRT联合机械通气复合式治疗重症手足口病患儿神经源性肺水肿的临床疗效。方法：将26例患儿随机分为复合式治疗组(亚低温 + CRRT + 机械通气组，13例)和对照组(机械通气组，13例)。分别记录患儿抢救成功率及上机时间，以及治疗前及治疗后两组患儿肝肾功能的变化。结果：复合式治疗组的抢救成功率明显高于对照组，上机时间明显短于对照组，并且治疗72小时后的复合式治疗组的肝肾功能明显优于对照组组，差异均具有统计学意义。结论：全身亚低温及CRRT联合机械通气的复合式治疗可以明显提高重症手足口病患儿抢救成功率，改善其预后，值得临床运用推广。

Abstract: Objective: To investigate the clinical curative effect of combined treatment by mechanical ventila-tion jointing systemic hypothermia and CRRT for neurogenic pulmonary edema with severe hand, foot and mouth disease in children. Methods: 26 cases were randomly divided into combined treatment group (hypothermia + CRRT + mechanical ventilation group, 13 cases) and control group (mechanical ventilation group, 13 cases). The rescue success rate and time of mechanical ventila-tion respectively, and the change of function of liver and kidney before and after treatment in two groups were recorded. Results: The rescue success rate of compound treatment group was ob-viously higher than that of control group; the time of mechanical ventilation was shorter than the control group; and the function of liver and kidney after 72 hours was better than control way. The differences were all statistically significant. Conclusion: The combined treatment with mechanical ventilation jointing systemic hypothermia and CRRT can obviously increase rescue success rate for children with neurogenic pulmonary edema in severe hand, foot and mouth disease, and improve the prognosis. It is worthy of clinical application.