基于时机理论的有创-无创序贯性机械通气疗法联合高流量氧疗在轻中度ARDS中的治疗效果  

Effect of Based-on-Timing Theory of Invasive-Noninvasive Sequential Mechanical Ventilation Therapy Combined with High-Flow Oxygen Therapy in Treatment of Mild-to-Moderate Acute Respiratory Distress Syndrome(ARDS)

作　　者：王冬妮 孙康 孙晓霞 秦臻 WANG Dongni;SUN Kang;SUN Xiaoxia;QIN Zhen(Department of Critical Care Medicine,Eighty-Second Hospital of Huai'an,Huai'an City,Jiangsu Province,223001,China)

机构地区：[1]江苏省淮安八十二医院重症医学科,江苏淮安223001

出　　处：《蛇志》2024年第3期303-306,共4页Journal of Snake

摘　　要：目的探讨基于时机理论的有创-无创序贯性机械通气疗法联合高流量氧疗在轻中度急性呼吸窘迫综合征(ARDS)中的治疗效果。方法选择2022年10月至2024年1月我院收治的80例轻中度ARDS患者作为研究对象,按随机数字表法分为对照组和观察组,每组40例。对照组实施常规机械通气联合高流量氧疗法,观察组予以基于时机理论的有创-无创序贯性机械通气联合高流量氧疗法。观察两组患者治疗24、48 h后的血气分析指标、循环指标、治疗相关指标和呼吸机相关性肺炎的发生情况。结果治疗24、48 h后,两组患者的呼吸频率(RR)、二氧化碳分压(PaCO_(2))、氧合指数(PaO_(2)/FiO_(2))、心率(HR)、平均动脉压(MAP)等循环指标比较,差异均无统计学意义(均P>0.05)。两组患者的有创机械通气时间、总机械通气时间、住ICU时间比较,观察组均明显短于对照组,差异均有统计学意义(P<0.05)。观察组的呼吸机相关性肺炎发生率低于对照组,差异有统计学意义(P<0.05)。结论基于时机理论的有创-无创序贯性机械通气疗法联合高流量氧疗应用于轻中度的ARDS患者的效果与常规治疗方法相当,但在机械通气持续时间、呼吸机相关性肺炎的发生方面具有明显优势,值得临床应用。Objective To investigate the therapeutic effect of based-on-timing theory of invasive-noninvasive sequential mechanical ventilation therapy combined with high-flow oxygen therapy in the treatment of mild-to-moderate ARDS.Methods Eighty patients with mild-to-moderate ARDS admitted to our hospital from October 2022 to January 2024 were selected as the research subjects and divided into the control group and the observation group by random number table method.The control group received conventional mechanical ventilation combined with high-flow oxygen therapy,while the observation group received based-on-timing theory of invasive-noninvasive sequential mechanical ventilation therapy combined with high-flow oxygen therapy.The blood gas analysis indicators,circulatory indicators,treatment-related indicators,and incidence of ventilator-associated pneumonia(VAP)were observed in the two groups at 24 and 48 h after treatment.Results After treatment for 24 and 48 h,the respiratory rate(RR),carbon dioxide partial pressure(PaCO_(2)),oxygenation index(PaO_(2)/FiO_(2)),heart rate(HR),and mean arterial pressure(MAP)of the two groups were comparable,with no statistically significant differences(all P>0.05).The total invasive mechanical ventilation time,total mechanical ventilation time,and ICU stay of the observation group were all significantly shorter than those of the control group,with statistically significant differences(all P<0.05).The incidence of VAP in the observation group was lower than that in the control group,with a statistically significant difference(P<0.05).Conclusion Based on the timing theory,invasive-non-invasive sequential mechanical ventilation therapy combined with high-flow oxygen therapy has the same effect as conventional therapy in mild to moderate ARDS patients,but it has obvious advantages in the duration of mechanical ventilation and the occurrence of ventilators associated pneumonia,and is worthy of clinical application.

关 键 词：时机理论 有创-无创序贯性机械通气 高流量氧疗 急性呼吸窘迫综合征 

分 类 号：R563[医药卫生—呼吸系统] R459.6[医药卫生—内科学]