有创-无创序贯与单纯有创机械通气治疗创伤性ARDS的回顾性研究  

Retrospective studies of treatment to traumatic acute respiratory distress syndrome by noninvasive-invasive sequential ventilation and invasive ventilation

作　　者：尹其翔[1] 梁亚鹏[1] 周峰[1] 

机构地区：[1]江苏大学附属医院急诊中心,江苏镇江212001

出　　处：《重庆医学》2016年第24期3376-3378,共3页Chongqing medicine

摘　　要：目的建立序贯机械通气治疗创伤性急性呼吸窘迫综合征(ARDS)的模式,并比较与单纯有创机械通气的差异。方法选取2010年8月至2015年5月入住该中心的创伤性ARDS并需机械通气的患者64例。分为两组,有创组32例采取单纯有创机械通气治疗,序贯组32例采取有创-无创序贯性机械通气治疗。比较序贯组拔管前与拔管24h后血气分析结果;两组间呼吸机相关肺炎(VAP)发生率、镇静剂使用量、有创通气时间、总机械通气时间、ICU住院时间及伤后28d临床结局。结果序贯组的VAP发生率、有创通气时间、总机械通气时间、ICU住院时间及临床预后均优于对照组,差异有统计学意义(P<0.01)。结论有创-无创序贯通气模式治疗创伤性ARDS,具有良好的临床疗效,可显著改善患者预后。Objective To construct the model of treating traumatic acute respiratory distress syndrome（ARDS） by sequential mechanical ventilation, and to compare the differences between this model and simple invasive mechanical ventilation. Methods Six- ty-four traumatic ARDS patients underwent mechanical ventilation were collected from August 2010 to May 2015 in our center. These patients were divided into two groups. Thirty-two samples in invasive group received simple invasive mechanical ventilation therapy while 32 samples in sequential group received sequential mvaslve-noninvasive ventilation therapy. A comparison was made on blood gas analysis of sequential group before and 24 h after extubation. Incidence of ventilator-associated pneumonia （VAP）, dosage of sedative, invasive ventilation time, total duration of mechanical ventilation, ICU hospitalization time and clinical prognosis 28 d after injury of these two groups were also compared. Results The incidence of VAP,dosage of sedative, total duration of me- chanical ventilation,ICU hospitalization time and clinical prognosis of sequential group were better than those of control group,and the difference had statistical significance（P〈0.01）. Conclusion Sequential invasive-noninvasive ventilation mod treatment in trau- matic ARDS has a better clinical efficiency, and can significantly improve clinical prognosis.

关 键 词：序贯性机械通气 呼吸窘迫综合征 成人 急性病 胸部损伤 

分 类 号：R563.8[医药卫生—呼吸系统]