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目的:通过脉搏指示剂连续心排量(PICCO)监护仪和血气分析,观察6%羟乙基淀粉(万汶)和5%白蛋白扩容治疗后对重度子痫前期并发毛细血管渗漏综合征(CLS)患者肺功能的影响。方法:选取62例重度子痫前期并发CLS产后患者,随机分为万汶组(30例)和白蛋白组(32例),采用PICCO监护仪,在扩容前、在扩容后8、16、24h记录血管外肺水指数(EVLWI)、取动脉血测定血气、计算氧合指数和肺泡动脉氧分压差(P(A-a)O2)及呼吸指数(RI)。结果:万汶组扩容后8、16、24h不同时间点EVLWI、P(A-a)O2和呼吸指数显著低于治疗前(P<0.05),万汶组扩容后氧合指数明显高于扩容前(P<0.05)。白蛋白组扩容后8、16、24hEVLWI、P(A-a)O2和呼吸指数显著高于万汶组(P<0.05);白蛋白组氧合指数明显低于万汶组(P<0.05)。结论:万汶扩容治疗不影响重度子痫前期并发CLS的肺功能,与其治疗毛细血管渗漏综合征有关。
OBJECTIVE: To observe the effects of 6% hydroxyethyl starch (Wen-Wen) and 5% albumin on the development of severe preeclampsia with capillary leak syndrome (CHF) through PICCO monitor and blood gas analysis. (CLS) patients with pulmonary function. Methods: Sixty-two patients with severe preeclampsia complicated with CLS postpartum were randomly divided into 10 groups (30 cases) and albumin group (32 cases). PICCO monitor was used before expansion. At 8, 16 and 24 hours after expansion The extravascular lung water index (EVLWI) was recorded. The arterial blood was taken to measure the blood gas. The oxygenation index (P (Aa) O2) and the respiratory index (RI) were calculated. Results: The EVLWI, P (Aa) O2 and respiratory index in the Wanwen group were significantly lower than those before treatment (P <0.05) at 8, 16 and 24 hours after expansion. The oxygenation index of the Wanwen group was significantly higher than that before treatment P <0.05). Albumin group expansive 8,16,24 hEVLWI, P (A-a) O2 and respiratory index was significantly higher than the wennian group (P <0.05); albumin oxygenation index was significantly lower than the Wandu group (P <0.05). CONCLUSION: Van-Wen dilation does not affect pulmonary function of patients with severe preeclampsia complicated with CLS, which is related to the treatment of capillary leak syndrome.