不同潮气量机械通气治疗外伤性急性呼吸窘迫综合征的临床对比研究  

Clinical Comparative Study of Different Tidal Volume Mechanical Ventilation in the Treatment of Traumatic Acute Respiratory Distress Syndrome

作　　者：韩永艳[1] 

机构地区：[1]河南省商丘市第一人民医院重症监护室,河南商丘476000

出　　处：《中国医药指南》2017年第11期18-19,共2页Guide of China Medicine

摘　　要：目的探讨不同潮气量机械通气治疗外伤性急性呼吸窘迫综合征的效果。方法抽取2013年1月至2015年4月我院接收的68例外伤性急性呼吸窘迫综合征患者,随机分为常规组与小潮气量组,各31例。常规组采用常规潮气量(10~12 m L/kg)治疗,小潮气量组采用小潮气量(6~8 m L/kg)治疗。对比两组患者治疗前后Pa CO2、氧合指数和肺泡灌洗液IL-6及TNF-α水平变化情况,统计两组患者VILI、MODS及病死率。结果治疗前两组患者Pa CO2、氧合指数相比差异无统计学意义(P>0.05),经治疗,小潮气量组Pa CO2水平明显优于常规组,差异有统计学意义(P<0.05);小潮气量组VILI(呼吸机所致肺损伤)、MODS(多器官功能障碍综合征)的发生率及病死率与常规组对比差异均有统计学意义(P<0.05);治疗前小潮气量组与常规组IL-6及TNF-α水平相比差异无统计学意义(P>0.05),经治疗,小潮气量组两项指标水平均优于常规组,差异有统计学意义(P<0.05)。结论采用小潮气量机械通气模式治疗外伤性急性呼吸窘迫综合征效果显著,且并发症发生率及病死率低。Objective To investigate the effect of different tidal volume mechanical ventilation in the treatment of traumatic acute respiratory distress syndrome. Methods 68 patients with traumatic acute respiratory distress syndrome received in our hospital from January 2013-2015 to April were selected.And they were randomly divided into normal group and the low tidal volume group, 31 cases in each. The treatment group was given conventional tidal volume（10-12 m L/kg） treatment; low tidal volume group was given low tidal volume（6-8 m L/kg） treatment. Pa CO2, oxygenation index and the level of IL-6 and TNF-were compared between the two groups before and after treatment, and the VILI, MODS and mortality of the two groups were statistically analyzed. Results There was no significant difference in Pa CO2 and oxygenation index between the two groups before treatment（P〈 0.05）. After treatment, the low tidal volume group Pa CO2 was significantly better than that of the conventional group, the difference was statistically significant（P0.05）; Low tidal volume group VILI（ventilator induced lung injury and MODS（multiple organ dysfunction syndrome） the occurrence rate and mortality rate when compared with the routine group, there were statistically significant differences（P0.05）; Before treatment, the low tidal volume group and the conventional group IL-6 and TNF-levels had no significant difference（P〉0.05）; After treatment, the low tidal volume group two indicators were better than that of the conventional group, and the difference was statistically significant（P0.05）; Conclusion The effect of low tidal volume mechanical ventilation in treatment of traumatic acute respiratory distress syndrome is significant. And it has a low rate of complications and mortality.

关 键 词：潮气量 机械通气 外伤性急性呼吸窘迫综合征 

分 类 号：R563.8[医药卫生—呼吸系统]