急性呼吸窘迫综合征应用小潮气量无创肺保护性通气策略的预后分析.doc

小潮气量肺保护通气策略治疗急性呼吸窘迫综合征的预后分析 张欣 赵子平*2 刘宁3 (1北京市朝阳区桓兴肿瘤医院重症医学科 北京 100122；2北京朝阳急诊抢救中心 北京 100122；3河北省胸科医院 河北石家庄 050041） 摘要：目的：探讨应用小潮气量肺保护性通气策略治疗急性呼吸窘迫综合征（ARDS）的预后情况。方法：ARDS患者80例，根据病床单双号分为治疗组和对照组，各40例，均给予常规治疗，治疗组采用小潮气量辅助/控制机械通气治疗，对照组采用肺复张/机械通气治疗。结果：2组治疗前Pa02、Pa02/Fi02和PaC02无明显差异，治疗后2h、24hPa02和Pa02/Fi02值明显上升，PaC02值明显下降(P0.05)，同一时间点2组间无统计学差异。治疗组的机械通气时间与住院时间都明显少于对照组 (P0.05)。治疗组呼吸机相关肺炎、恶心呕吐和肺出血并发症发生率明显低于对照组(P0.05)。结论：小潮气量肺保护性通气策略应用于ARDS的治疗中，能有效保持患者动脉血气的稳定，加快患者的恢复，减少并发症。 关键词：急性呼吸窘迫综合征；肺保护性通气策略；通气；小潮气量 The prognosis analysis of small tidal volume noninvasive lung protective ventilation strategies for acute respiratory distress syndromeAbstract: Objective: To investigate the prognosis of small tidal volume noninvasive lung protective ventilation strategies for treating acute respiratory distress syndrome. Methods: 80 cases of acute respiratory distress syndrome accorded the odd and even numbers of beds were equally divided into the treatment group and the control group, two groups were given conventional treatment, and the treatment group were uesed low tidal volume assist / control mechanical ventilation, the control group were given lung recruitment / mechanical ventilation. Results: The Pa02, Pa02/Fi02 and PaC02 values between two groups before treatment compared had no significant differences, and the Pa02 and Pa02/Fi02 values were increased significantly after treatment at all time points, PaC02 values were decreased significantly (P 0.05), while there had no statistically significant between the two groups compared. The mechanical ventilation time and hospital stay of the treatment group were significantly less than the control group (P 0.05). there were no deaths in both groups, but the ventilator-associated vomiting and pulmonary hemorrhage overall complication rate of the treatment group were significantly lower than the control group (P 0.05). Conclusion: Noninvasive low tidal volume lung protective ventilation strategy applied pediatric respiratory distress syndro