综合治疗急性呼吸窘迫综合征的疗效观察  

Observation on Therapeutic Effect of Comprehensive Treatment for Acute Respiratory Distress Syndrome

作　　者：万小兵[1] 陈宇洁[1] 陆海英[1] 

机构地区：[1]四川省第四人民医院呼吸内科,成都610016

出　　处：《医学综述》2015年第7期1324-1325,共2页Medical Recapitulate

摘　　要：目的探讨呼吸支持、液体管理、抗炎和抗凝等综合方法治疗急性呼吸窘迫综合征(ARDS)的疗效。方法对2006年1月至2012年12月四川省第四人民医院呼吸内科收治的ARDS患者52例,在积极处理原发病基础上,应用呼吸支持、液体管理、抗炎和抗凝等综合治疗措施,观察治疗前后相关临床指标的变化。结果 52例ARDS患者死亡12例,病死率为23.1%;治疗48 h后,患者血氧饱和度、p H值、动脉血氧分压、碳酸氢根显著高于治疗前[(0.89±0.13)比(0.80±0.30)、(7.9±0.7)比(7.1±0.6)、(82.4±6.9)mm Hg(1 mm Hg=0.133 k Pa)比(62.3±7.9)mm Hg、(21.2±2.5)mm Hg比(19.7±3.9)mm Hg],二氧化碳分压显著低于治疗前[(40.6±6.9)mm Hg比(46.3±8.4)mm Hg,P<0.01]。结论经机械通气、液体管理、抗炎和抗凝等综合措施治疗ARDS患者效果较好,治疗前后各项指标均有好转迹象,可有效降低其病死率。Objective To explore the application of respiratory support,fluid management,anti-inflammatory and anticoagulant therapy in treating acute respiratory distress syndrome（ARDS）.Methods A total of 52 ARDS patients admitted in Sichuan Fourth People＇s Hospital from Jan.2006 to Dec.2012 were selected.On the basis of active treatment for primary disease,the patients were treated by comprehensive therapies,including respiratory support,fluid management,anti-inflammatory and anticoagulant,the changes of clinical indicators were observed before and after treatment.Results After treatment,12 cases out of 52 died,the mortality rate was 23.1%.And 48 h after treatment,the transcutaneous oxygen saturation,p H value,oxygen partial pressure,bicarbonate of the patients were higher than those before treatment,there were statistically significant differences[（0.89 ± 0.13） vs（0.80 ± 0.30）,（7.9 ± 0.7） vs（7.1 ± 0.6）,（82.4 ± 6.9）mm Hg vs（62.3 ± 7.9） mm Hg,（21.2 ± 2.5） mm Hg vs（19.7 ± 3.9） mm Hg],while partial pressure of carbon dioxide was significantly lower than that before treatment[（40.6 ± 6.9） mm Hg vs（46.3 ± 8.4） mm Hg,P〈0.01].Conclusion The comprehensive therapy of mechanical ventilation,fluid management,antiinflammatory and anticoagulant for ARDS has good effect,clinical indicators of the patients generally become better after treatment.It can effectively reduce the mortality.

关 键 词：急性呼吸窘迫综合征 机械通气 液体管理 抗炎 营养支持 

分 类 号：R720.5[医药卫生—儿科]