肺复张联合小潮气量机械通气对急性呼吸窘迫综合征的影响  

Effect of Lung Recruitment Combined with Low Tidal Volume Mechanical Ventilation on Acute Respiratory Distress Syndrome

作　　者：石中方 SHI Zhongfang(Jianli Hospital of Traditional Chinese Medicine,Hubei Province,Jianli 433300,China)

机构地区：[1]湖北省监利市中医医院,湖北监利433300

出　　处：《中国医学创新》2022年第14期43-47,共5页Medical Innovation of China

摘　　要：目的:探讨肺复张联合小潮气量机械通气对急性呼吸窘迫综合征(ARDS)的临床影响。方法:纳入2019年6月-2020年3月于监利市中医医院治疗的82例ARDS患者,随机将患者分为对照组(41例)和观察组(41例)。对照组予以肺复张机械通气治疗,观察组采用肺复张联合小潮气量机械通气治疗。观察两组治疗前及治疗后动脉血气相关指标、炎症因子水平、临床预后等指标差异。结果:治疗前,两组患者血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))、二氧化碳分压(PaCO_(2))及炎症因子水平比较,差异均无统计学意义(P>0.05);治疗后,两组SpO_(2)、PaO_(2)、PaO_(2)/FiO_(2)及PaCO_(2)较治疗前均有显著改善(P<0.05);治疗后,观察组PaO_(2)、PaO_(2)/FiO_(2)及PaCO_(2)水平均显著优于对照组(P<0.05),但两组SpO_(2)水平比较,差异均无统计学意义(P>0.05)。治疗后,两组白细胞介素-6(IL-6)、白细胞介素-8(IL-8)水平均显著下降(P<0.05),且观察组治疗后3、5 d的IL-6、IL-8水平均明显低于对照组,差异均有统计学意义(P<0.05)。观察组和对照组死亡率(19.51% vs 24.39%),并发症发生率(21.95% vs 26.83%)比较,差异均无统计学意义(P>0.05)。结论:肺复张联合小潮气量机械通气能有效提高ARDS患者机械通气治疗效果,并减轻炎症反应,有利于改善患者预后。Objective:To investigate the clinical influences of lung recruitment combined with low tidal volume mechanical ventilation on acute respiratory distress syndrome (ARDS).Method:A total of 82 patients with ARDS treated in Jianli Hospital of Traditional Chinese Medicine from June 2019 to March 2020 were randomly divided into control group (41 cases) and observation group (41 cases).The control group received lung recruitment mechanical ventilation,while the observation group received lung recruitment combined with low tidal volume mechanical ventilation.The changes of arterial blood gas,inflammation factors and clincal outcomes were observed before and after treatment of the two groups.Result:Before treatment,there were no significant differences in the levels of the blood oxygen saturation (SpO_(2)),arterial blood oxygen partial pressure (PaO_(2)),oxygenation index (PaO_(2)/FiO_(2)),partial pressure of carbon dioxide (PaCO_(2)) and inflammatory factors in the two groups (P>0.05);after treatment,the levels of SpO_(2),PaO_(2),PaO_(2)/FiO_(2) and PaCO_(2) were significantly improved in both groups (P<0.05);after treatment,the levels of PaO_(2),PaO_(2)/FiO_(2),PaCO_(2) of the observation group were significantly better than those of the control group,the differences were statistically significant (P<0.05),but there were no significant differences in SpO_(2) between the two groups(P>0.05).After treatment,the levels of interleukin-6 (IL-6),interleukin-8 (IL-8) in the two groups were both significantly decreased (P<0.05),and those of the observation group 3 and 5 d after treatment were significantly lower than those of the control group,the differences were statistically significant (P<0.05).There were no significant differences in mortality (19.51% vs 24.39%) and complication rate (21.95% vs 26.83%) between the observation group and the control group (P>0.05).Conclusion:The lung recruitment combined with low tidal volume mechanical ventilation can improve the effects of mechanical ventilation in patients of ARDS,and redu

关 键 词：急性呼吸窘迫综合征 机械通气 肺复张 小潮气量 

分 类 号：R563.8[医药卫生—呼吸系统]