打开肺通气策略治疗重症ARDS的可行性研究  

Feasibility study on open lung ventilation methods in patients with grave ARDS

作　　者：王晓芝[1] 吕长俊[1] 李嘉文 郝东[1] 王涛[1] 李志[1] 

机构地区：[1]滨州医学院附属医院,山东滨州256603 [2]龙口市北海医院

出　　处：《山东医药》2008年第13期14-16,共3页Shandong Medical Journal

基　　金：山东省医药卫生科技发展计划立项课题(05HW003)

摘　　要：目的探讨打开肺通气策略治疗重症急性呼吸窘迫综合征(ARDS)的临床价值。方法对14例重症ARDS患者采用肺复张手法联合双水平正压通气,动态观察肺开放策略实施对动脉血气指标、中心静脉压(CVP)和平均动脉压(MAP)和肺顺应性的变化,并与传统呼吸方式就带机时间、ICU住院时间和病死率、并发症等对比。结果患者肺顺应性明显提高,氧合功能障碍明显改善,待机时间缩短、存活率提高。结论肺开放策略治疗重症ARDS明显改善了患者的氧合功能,对血流动力学影响小,安全有效地提高了抢救成功率。Objective To investigate the clinical value of open lung ventilation strategy in patients with acute respiratory distress syndrome （ARDS）. Methods 14 patients with ARDS were treated with lung recruitment maneuvers combined with B/PAP. The influence of open lung ventilation strategy on arterial blood gas indexs, cemral venous pressure （ CVP）, mean arterial pressure（MAP） and pulmonary compliance were observed dynamically ,and the duration of ventilation time, length of stay in ICU, death rate and complication of patients with open lung ventilation strategy were compared with that of patients with traditional breath mode. Results In patients, pulmonary compliance was increased obviously, oxygenation functional impairment was improved significantly , duration of ventilation time was decurtated and survival rate was in- creased. Conclusions Open lung ventilation strategy can improve the oxygenation function and achievement ratio of sal- vage , and has little influence on hemedynamics in the treatment of grave ARDS.

关 键 词：肺开放策略 呼吸窘迫综合征 双水平正压通气 肺复张手法 

分 类 号：R563.8[医药卫生—呼吸系统]