不同机械通气模式治疗老年重症胸部损伤合并急性呼吸窘迫综合征的疗效评价  

Efficacy evaluation of different mechanical ventilation modes in the treatment of elderly severe chest injury patients complicated with acute respiratory distress syndrome

作　　者：胡琪清 HU Qi-qing.(Department of Critical Care Medicine, Tongshan District People＇s Hospital of Xuzhou City, Xuzhou 221000, China)

机构地区：[1]徐州市铜山区人民医院重症医学科,221000

出　　处：《中国实用医药》2018年第29期19-21,共3页China Practical Medicine

摘　　要：目的评价不同机械通气模式治疗老年重症胸部损伤合并急性呼吸窘迫综合征的疗效。方法 60例老年重症胸部损伤合并急性呼吸窘迫综合征患者,随机分为对照组与观察组,每组30例。对照组给予同步间歇性指令通气联合呼气末正压通气,观察组给予连续性气道通气联合压力支持。比较两组患者治疗效果、呼吸模式参数及血气分析指标。结果相同吸入氧气浓度(FiO_2)下,观察组患者每分通气量(MV)及氧分压(PaO_2)水平高于对照组,气道峰压(PIP)及二氧化碳分压(PaCO_2)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,两组患者PaO_2、PaCO_2、血氧饱和度(SaO_2)水平比较差异无统计学意义(P>0.05);观察组患者氧合指数(PaO_2/FiO_2)为(210.25±8.75)mm Hg(1 mm Hg=0.133 kPa),高于对照组的(204.75±9.50)mm Hg,差异具有统计学意义(P<0.05)。两组患者总有效率比较差异无统计学意义(χ~2=0.3509, P>0.05)。结论给予老年重症胸部损伤合并急性呼吸窘迫综合征患者不同机械通气模式,均能取得较好的效果,要根据患者具体情况选择适合的治疗方式。Objective To evaluate the efficacy of different mechanical ventilation modes in the treatment of elderly severe chest injury patients complicated with acute respiratory distress syndrome. Methods A total of 60 elderly severe chest injury patients complicated with acute respiratory distress syndrome were randomly divided into control group and observation group, 30 cases in each group. The control group was given synchronous intermittent mandatory ventilation combined with positive end-expiratory pressure ventilation, the observation group was given continuous airway ventilation combined with pressure support. The therapeutic effect, respiratory mode parameters and blood gas analysis indexes between the two groups were compared. Results Under the same concentration of fraction of inspired oxygen（FiO2）, the levels of minute ventilation（MV） and partial pressure of oxygen（PaO2） in the observation group were significantly higher than those in the control group, and the levels of peak inspiratory pressure（PIP） and partial pressure of carbon dioxide（PaCO2） in the observation group were significantly lower than those in the control group, the differences were statistically significant（P〈0.05）. After treatment, there were no significant differences in the levels of PaO2, PaCO2 and oxygen saturation（SaO2） between the two groups（P〉0.05）. The oxygenation index（PaO2/FiO2） of the observation group was（210.25±8.75） mm Hg（1 mm Hg=0.133 kPa）, which was significantly higher than（204.75±9.50） mm Hg, the difference was statistically significant（P〈0.05）. There was no significant difference in the total effective rate between the two groups（χ^2=0.3509, P〉0.05）. Conclusion Different mechanical ventilation modes for elderly severe chest injury patients complicated with acute respiratory distress syndrome can achieve better results. Appropriate treatment methods should be selected according to the specific conditions of the patients.

关 键 词：不同机械通气模式 老年重症胸部损伤合并急性呼吸窘迫综合征 疗效 

分 类 号：R563.8[医药卫生—呼吸系统]