有创-无创序贯性机械通气结合舒普深治疗对重症ARDS患者疗效及动脉血气分析和呼吸力学参数的影响  

Effects of Invasive-Noninvasive Sequential Mechanical Ventilation Combined with Surfactant Protein D on the Clinical Outcomes and Arterial Blood Gas Analysis and Respiratory Mechanics Parameters of Patients with Severe ARDS

作　　者：许瑾瑾 谢红伟 王素红 XU Jin-jin;XIE Hong-wei;WANG Su-hong(Department of Respiratory and Critical Care Medicine,Luoyang No.1 People's Hospital,Luoyang,Henan,471002,China)

机构地区：[1]洛阳市第一人民医院呼吸与危重症医学科,河南洛阳471002

出　　处：《中国血液流变学杂志》2023年第2期214-217,298,共5页Chinese Journal of Hemorheology

摘　　要：目的探讨有创-无创序贯性机械通气结合舒普深治疗对重症急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)患者疗效及动脉血气分析和呼吸力学参数的影响。方法选取2019年10月—2022年10月洛阳市第一人民医院收治的102例重症ARDS患者,随机分为对照组和观察组,每组51例。对照组采用常规有创-无创序贯性机械通气治疗,观察组在此基础上加用舒普深治疗。比较两组患者的临床资料、动脉血气分析、呼吸力学参数、撤机时间、RICU住院时间、28 d生存率等指标。结果两组患者的一般资料、入院时的动脉血气分析和呼吸力学参数差异无统计学意义(P>0.05)。观察组治疗后的PaO_(2)、PaO_(2)/FiO_(2)、pH值均高于对照组,PaCO_(2)低于对照组(P<0.05);观察组治疗后的平均气道压力、呼吸阻力、呼吸功均低于对照组(P<0.05);观察组的撤机时间、RICU住院时间均短于对照组(P<0.05);观察组的28 d生存率高于对照组(P<0.05)。结论有创-无创序贯性机械通气结合舒普深治疗可改善重症ARDS患者的动脉血气分析和呼吸力学参数,缩短撤机时间和RICU住院时间,提高28 d生存率,值得临床推广应用。Objective To investigate the effects of invasive-noninvasive sequential mechanical ventilation combined with surfactant protein D on the clinical outcomes and arterial blood gas analysis and respiratory mechanics parameters of patients with severe acute respiratory distress syndrome(ARDS).Methods A total of 102 patients with severe ARDS admitted to Luoyang No.1 People's Hospital from October 2019 to October 2022 were randomly divided into control group and observation group,with 51 cases in each group.The control group received conventional invasive-noninvasive sequential mechanical ventilation,while the observation group received surfactant protein D treatment on this basis.The clinical data,arterial blood gas analysis,respiratory mechanics parameters,weaning time,RICU stay time,28-day survival rate and other indicators of the two groups were compared.Results There was no significant difference in the general data,arterial blood gas analysis and respiratory mechanics parameters at admission between the two groups(P>0.05).After treatment,the PaO_(2),PaO_(2)/FiO_(2)and pH values of the observation group were higher than those of the control group,while the PaCO_(2)was lower than that of the control group(P<0.05).The mean airway pressure,respiratory resistance and work of breathing of the observation group were lower than those of the control group(P<0.05).The weaning time and RICU stay time of the observation group were shorter than those of the control group(P<0.05).The 28-day survival rate of the observation group was higher than that of the control group(P<0.05).Conclusion Invasive-noninvasive sequential mechanical ventilation combined with surfactant protein D can improve the arterial blood gas analysis and respiratory mechanics parameters of patients with severe ARDS,shorten the weaning time and RICU stay time,and increase the 28-day survival rate,which is worthy of clinical promotion and application.

关 键 词：有创-无创序贯性机械通气 舒普深 重症ARDS 动脉血气分析 呼吸力学参数 

分 类 号：R563[医药卫生—呼吸系统]