不同呼气末正压的有创机械通气联合密闭式吸痰术治疗心源性肺水肿的临床效果  

Invasive Mechanical Ventilation with Different Positive End-expiratory Pressures Combined with Closed Sputum aspiration:Clinical Effectiveness Study in Patients with Cardiogenic Pulmonary Edema

作　　者：梁德金 黄平芳[1] 覃凤兰 Liang Dejin;Huang Pingfang;Qin Fenglan(Qinzhou First People's Hospital,Qinzhou 535000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]钦州市第一人民医院,广西壮族自治区钦州535000

出　　处：《中外医药研究》2024年第1期48-50,共3页JOURNAL OF CHINESE AND FOREIGN MEDICINE AND PHARMACY RESEARCH

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(编号:Z-N20221874)。

摘　　要：目的:评估不同呼气末正压(PEEP)的有创机械通气联合密闭式吸痰术治疗心源性肺水肿的临床效果。方法:选取2021年7月—2023年7月钦州市第一人民医院收治的心源性肺水肿患者60例为研究对象,按照随机数字表法分为对照组与研究组,各30例。两组均接受机械通气治疗,研究组给予高PEEP联合密闭式吸痰术,对照组给予低PEEP联合密闭式吸痰术。比较两组临床指标、肺功能、血气功能指标、疼痛评分。结果:研究组住院时间、上机时间短于对照组,治疗费用、并发症发生率低于对照组,差异有统计学意义(P<0.05);治疗后,研究组气道闭合压、气道阻力水平低于对照组,肺顺应性水平高于对照组,差异有统计学意义(P<0.05);治疗后,研究组氧合指数、二氧化碳分压、酸碱度、氧分压均优于对照组,差异有统计学意义(P<0.05);治疗后,两组视觉模拟评分法评分均低于治疗前,研究组低于对照组,差异有统计学意义(P<0.05)。结论:高PEEP联合密闭式吸痰术治疗心源性肺水肿的效果更显著,可以帮助患者改善肺功能、血气指标,缩短住院时间,安全性高,治疗费用低。Objective:To evaluate the clinical effect of invasive mechanical ventilation with different positive end-expiratory pres⁃sure(PEEP)combined with closed suction for the treatment of cardiogenic pulmonary edema.Methods:60 patients with cardio⁃genic pulmonary edema admitted to Qinzhou First People's Hospital from July 2021 to July 2023 were selected for the study,and they were divided into the control group and the study group according to the method of randomized numerical table,each with 30 cases.Both groups received mechanical ventilation,and high PEEP combined with closed suction was given to the study group,while low PEEP combined with closed suction was given to the control group.Clinical indexes,lung function,blood gas function indexes,and pain score were compared between the two groups.Results:Hospitalization time and mechanical ventilation time of the study group were shorter than those of the control group,and the treatment cost and complication rate were lower than those of the control group,with statistically significant differences(P<0.05);after the treatment,airway closure pressure and airway resis⁃tance of the study group was lower than those of the control group,and the level of lung compliance was higher than that of the control group,with statistically significant differences(P<0.05);after the treatment,oxygenation index,partial pressure of carbon dioxide,acid-base level,and oxygen partial pressure of the study group were better than those of the control group,and the difference was sta⁃tistically significant(P<0.05);after treatment,the scores of visual analog scoring method of both groups were lower than those before treatment,and the study group was lower than the control group,and the difference was statistically significant(P<0.05).Conclusion:High PEEP combined with closed suctioning is more effective in treating cardiogenic pulmonary edema,which can help patients im⁃prove lung function and blood gas indexes,shorten hospitalization time,with higher safety and lower treatment cost.

关 键 词：呼气末正压 有创机械通气 心源性肺水肿 肺功能 血气指标 

分 类 号：R541.63[医药卫生—心血管疾病] R472[医药卫生—内科学]