保护性通气策略治疗ARDS的临床研究  

Clinical Study of ARDS Treatment with Protection Mechanotherapy

作　　者：杨萍[1] 关建华 陈剑颖 王智勇 陈黎仙 

机构地区：[1]福建莆田学院临床医学系 [2]福建省莆田市第一医院呼吸内科,351100

出　　处：《齐齐哈尔医学院学报》2003年第9期965-966,共2页Journal of Qiqihar Medical University

摘　　要：目的　探讨应用保护性通气策略的机械通气治疗ARDS效果。方法　使用呼吸机小潮气量与肺开放策略 (参数VT :4.8～ 8.0ml/kg、PSV :12～ 16cmH2 O、PEEP :5～ 13cmH2 O、RR :18～ 2 0次/min ,维持气压峰压 <5 0cmH2 O ,平台压 <35cmH2 O ,峰值流速 18～ 2 0L/min) ,治疗ARDS 2 7例。结果　 2 7例机械通气时间 2 8～ 16 8.7h ,治愈出院 2 1例 ,死亡 6例 ,死亡率 2 6 .1%,未出现气压伤现象 ,出现呼吸机相关肺炎 3例。结论　ARDS的机械通气方法采用个体化保护性通气策略 ,其治愈率高 ,死亡率低 ,并发症少 ,个体化保护性通气策略应该普遍推广应用 ,提高ARDS抢救成功率。Objective To discuss the tactics of applying passable machines to treat ARDS. Methods To use a small quantity of humidity in respiratory machine and lung-opened tactics ( Parameter VT:4.8ml～8.0ml/kg, PSV:12～16 cm H 2O,PEEP:5～13 cm H 2O,RR:18～20 times/min maintain Peak Pressure lower than 50cm H 2O,level Pressure lower than 35cm H 2O, Peak value flow meter lower than 18～12 L/m),and so treated ARDS 27 cases. Results 27 cases got mechanical passable treatment for 28～168.7 hours,among them cured 21 cases, died 6 cases, death rate 26.1%,pressure injury didn’t occur, 3 cases related pneumonia of respiration function appeared. Conclusions Mechanical passable methods making use of individual protective passable tactics can show many beneficial points, such as,cure rate high, death rate low, complication fewer, so this tactics must be universally used to improve successful rescuer rate in ARDS.

关 键 词：保护性通气策略 治疗 ARDS 临床研究 气管插管 呼吸机相关性肺损伤 血气分析 

分 类 号：R563.8[医药卫生—呼吸系统] R605.973[医药卫生—内科学]