| 肺内和肺外源性ARDS患者行肺保护性通气临床资料对比研究 |
| 投稿时间：2016-06-11 修订日期：2016-06-20 点此下载全文 |
| 引用本文：王君兰,梁宗安,李凯.肺内和肺外源性ARDS患者行肺保护性通气临床资料对比研究[J].医学研究杂志,2017,46(2):23-26 |
| DOI：
10.11969/j.issn.1673-548X.2017.02.008 |
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| 基金项目:国家自然科学基金资助项目（81201851） |
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| 中文摘要:目的 比较肺保护性通气对肺内和肺外源性急性呼吸窘迫综合征（ARDS）患者的临床疗效，为不同类型急性呼吸窘迫综合征治疗提供依据。方法 选取2014年2月~2015年12月笔者医院收治的47例肺内源性急性呼吸窘迫综合征患者作为内源组，同期47例肺外源性急性呼吸窘迫综合征患者作为外源组。两组均在常规治疗的基础上进行非保护性通气策略治疗。综合比较两组患者呼吸力学指标、血气分析值、住院时间等差异。结果 两组患者RM前，RM后1、2、6、12h，Ppeak、Pplat、Pmean等指标比较差异均无统计学意义（P>0.05）；RM后30min，内源组Ppeak、Pplat、Pmean水平分别为48.95±4.17cmH2O（1cmH2O=0.098kPa）、38.45±4.18cmH2O、15.85±2.97cmH2O，均比外源组高（P<0.05）；行肺保护性通气策略后30min，内源组SaO2、PaO2、SaO2/FiO2等动脉血气指标均低于对照组P<0.05）；肺保护性通气策略后1、2、6、12h，两组SaO2、PaO2、SaO2/FiO2等动脉血气指比较差异无统计学意义（P>0.05）；内源组、外源组患者住院时间分别为14.96±3.85天、15.41±3.72天，两组比较，差异无统计学意义（P>0.05）。结论 肺保护性通气策略在治疗内源性和外源性急性呼吸窘迫综合征均有明显疗效；在改善改善呼吸力学指标和动脉血气值等方面，对外源性急性呼吸窘迫综合征效果更好。 |
| 中文关键词:肺保护性通气 急性呼吸窘迫 呼吸力学 血气分析 |
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| Clinical Effect of Lung Protective Ventilation Strategy for Lung Acute Respiratory Distress Syndrome(ARDS) and Pulmonary Exogenous ARDS |
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| Abstract:Objective To investigate the clinical effect of lung protective ventilation strategy for lung ARDS and pulmonary exogenous ARDS. Methods Forty seven cases of lung ARDS patients were selected as lung group, while 47 cases of pulmonary exogenous ARDS patients were selected as exogenous group. All the patients selected in this research were treated with conventional therapy and lung protective ventilation strategy. The lung mechanics data, blood gas analysis data and hospital stay time of the two groups were compared. Results There was no significant difference in lung mechanics data between the two groups before RM and 1h, 2h after RM (P>0.05). 30min after RM, the Ppeak, Pplat, Pmean of lung group were higher than exogenous group(P<0.05). There was no significant difference in blood gas analysis data between the two groups 1h, 2h after RM(P>0.05). 30min after RM, the SaO2, PaO2, SaO2/FiO2 of lung group were lower than exogenous group(P<0.05). There was no significant difference in hospital stay time between the two groups(P>0.05). Conclusion Lung protective ventilation strategy has exact effect for both lung ARDS and pulmonary exogenous ARDS. And it does better in improving lung mechanics and blood gas analysis for exogenous ARDS. |
| keywords:Lung protective ventilation strategy Acute respiratory distress syndrome Lung mechanics Blood gas analysis |
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