亚低温下呼气末正压通气对成人急性呼吸窘迫综合征氧代谢情况及预后结局的影响研究  

Effect of Positive End-expiratory Pressure Ventilation Under Mild Hypothermia on Oxygen Metabolism and Prognosis in Adult Acute Respiratory Distress Syndrome

作　　者：周婧 何炎佳 Zhou Jing;He Yanjia(ICU,The First People’s Hospital of Nanyang,Nanyang,Henan,473000,China)

机构地区：[1]南阳市第一人民医院重症医学科,河南南阳473000

出　　处：《黑龙江医学》2024年第15期1819-1821,共3页Heilongjiang Medical Journal

摘　　要：目的:观察亚低温下呼气末正压通气(PEEP)对改善成人急性呼吸窘迫综合征(ARDS)氧代谢情况及预后结局的影响。方法:选取2021年5月—2022年5月在南阳市第一人民医院接受持续正压通气治疗的126例ARDS患者作为研究对象。采用抽签法将患者分为两组,每组各63例。对照组予以常规体温下PEEP治疗。观察组予以亚低温下PEEP治疗。比较两组患者治疗前后的肺部炎症指标、氧代谢指标变化情况以及两组患者的治疗情况、预后结局。结果:治疗后,观察组患者的肺部局部白细胞介素-6(IL-6)、血清降钙素原(PCT)、C-反应蛋白(CRP)水平均低于对照组,差异有统计学意义(t=4.973、6.714、4.442,P<0.05);观察组患者的氧分指数(P/F)、混合静脉血氧饱和度(SvO2)高于对照组、血清乳酸水平(LAC)水平低于对照组,差异有统计学意义(t=2.901、2.974、10.809、P<0.05);观察组的肺顺应性高于对照组,ICU住院时长、机械通气时长均低于对照组,差异有统计学意义(t=9.476、6.907、3.530,P<0.05);观察组患者并发症发生率(7.94%)低于对照组(19.05%)、病死率(4.76%)低于对照组(15.87%),差异有统计学意义(χ^(2)=5.287、6.671,P<0.05)。结论:采用亚低温技术配合PEEP可促进ARDS患者的肺部炎症反应及氧代谢情况恢复,可增加患者临床获益并改善预后结局。Objective:To observe the effect of PEEP under mild hypothermia on improving the oxygen metabolism and prognosis of adult ARDS.Methods:126 adult patients with ARDS who received continuous positive pressure ventilation treatment in ICU of the hospital from May 2021 to May 2022 were selected as the study subjects.The patients were divided into two groups by drawing lots.Among them,63 patients in the control group were treated with PEEP under normal temperature,and 63 patients in the observation group were treated with PEEP under mild hypothermia.The changes of lung inflammation index,oxygen metabolism index,and the treatment and prognosis of the two groups were compared before and after treatment.Results:After different treatment,the local IL-6,the serum PCT and CRP were lower than the control group(t=4.973,6.714,4.442;P<0.05).P/F,SvO2 were higher than those in the control group.LAC was lower than that in the control group(t=2.901,2.974,10.809;P<0.05).The lung compliance of the observation group was higher than that of the control group,the length of hospitalization in ICU and the length of mechanical ventilation were lower than those of the control group(t=9.476,6.907,3.530;P<0.05).The complication rate(7.94%)and the mortality rate(4.76%)were lower than those in the control group 15.87%(χ^(2)=5.287,6.671;P<0.05).Conclusion:The use of mild hypothermia combined with PEEP can promote the recovery of pulmonary inflammatory reaction and oxygen metabolism in adult patients with ARDS,increase the clinical benefits of patients,and improve the prognosis.

关 键 词：成人急性呼吸窘迫综合征 亚低温技术 呼气末正压通气 氧代谢情况 预后结局 

分 类 号：R563.8[医药卫生—呼吸系统]