肺复张治疗急性A型主动脉夹层术后呼吸功能不全的临床研究  

Clinical Research on Lung Recruitment Maneuver for Postoperative Respiratory Insufficiency of Acute Type A Aortic Dissection Surgery

作　　者：程永庆[1] 葛敏[1] 邵俊[1] 陈涛[1] 王东进[1] 

机构地区：[1]南京大学医学院附属鼓楼医院心胸外科ICU,210008

出　　处：《医学研究杂志》2014年第5期86-88,共3页Journal of Medical Research

基　　金：南京市科技计划项目(201303004)

摘　　要：目的探讨肺复张在急性A型主动脉夹层术后呼吸功能不全的治疗效果。方法2011年4月～2013年5月笔者所在科室急性A型主动脉夹层术后呼吸功能不全患者26例，随机分为两组：对照组（n=13），行同步间歇指令通气（SIMV）结合呼气末正压（PEEP）治疗；肺复张组（n=13），行吸气压（IP）结合PEEP压力递减肺复张治疗，对比两组患者肺复张前后呼吸和循环参数的变化。结果肺复张组患者氧合指数（PaO2／FiO2）明显改善，并且能较好维持。肺复张期间患者的血流动力学指标保持稳定。结论肺复张是治疗急性A型主动脉夹层术后呼吸功能不全的一种安全有效的方法，采用压力递减方案能够维持血流动力学稳定。Objective To investigate the treatment of lung recruitment maneuver （RM） on postoperative respiratory insufficiency of acute type A aortic dissection （AAD） surgery. Methods From April 2011 to May 2013,twenty six patients undergone AAD surgery with postoperative respiratory insufficiency were randomly allocated into two groups： control group （n = 13 ）, receiring SIMV combined with PEEP treatment; RM group（ n = 13）, receiring decreased inspiratory pressure（IP） combined with PEEP RM treatment. The respiration and circulation variables were compared between the two groups. Results The oxygenation index of RM group was improved significantly and maintained well. During RM,the haemodynamics were stable. Conclusion Lung recruitment maneuver is an effective and safe method to treat the patients with respiratory insufficiency after AAD surgery,and the haemodynamics keep stable by decreased pressure way.

关 键 词：急性A型主动脉夹层 术后 呼吸功能不全 肺复张 

分 类 号：R563[医药卫生—呼吸系统]