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时间:2020-04-12
《《肺保护性通气策略治疗肺内和肺外源性急性呼吸窘迫综合征的临床对比》.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、.JournalofChinaPrescriptionDrugVo1.13No.6论著.123肺保护性通气策略治疗肺内和1159~源性急性呼吸窘迫综合征的临床对比袁庆杰,李连弟(1青岛大学医学院附属医院重症医学科、山东省潍坊市寒亭区人民医院,山东青岛266003;2青岛大学医学院附属医院重症医学科,山东青岛266003)【摘要】目的对采取肺保护性通气策略治疗的肺内和肺外源性急性呼吸窘迫综合征的患者临床差异进行比较分析。方法选取诊断为急性呼吸窘迫综合征的患者86例,根据原发性、继发性分为两组:肺内
2、急性呼吸窘迫综合征组(ARDSp组)和肺外源性急性呼吸窘迫综合征组(ARDSexp组)。对两组患者的呼吸力学、血气指标、平均上呼吸机时间和住院时间进行比较分析。结果肺保护性通气策略后30s内PIP(气道峰压)、Pplat(气道平台压)、Pm(平均气道压)均有明显提高<0.05);肺保护性通气策略后30s,5rain,15rain,30minARDSp组和ARDSexp组肺Crs(肺顺应性)均明显增加,两组比较,ARDSexp组增加更显著3、SaO2,PaO,PaO2/Fi0均增高(P<0.05),两组比较ARDSexP组增高更显著(P<0.05);PaCO2复张前后无明显变化(P>0.05)。两组机械通气时间比较差异无统计学意义(P>0.05)。两组住院时间比较差异无统计学意义(P>O.05)。结论对于ARDS患者应用肺保护性策略进行治疗,能够改善患者的氧合,提高抢救成功率,改善患者的预后,对于肺外源性急性呼吸窘迫综合征治疗的效果明显优于肺内急性呼吸窘迫综合征。【关键词】肺保护性通气策略;肺内急性呼吸窘迫综合征;肺外源性急性呼吸窘4、迫综合征Lungprotectiveventilationstra~iesinthelungsandpulmonaryexogenousclinicalcomparisonofacuterespiratorydistresssyndromeYUANQing-fie,LILian-di.HospitalafiliatedofQingdaouniversitymedicalcolegeintensivemedicine,shandongweifanghan~ngdistrictpeople'shos5、piml,Qingdao266003,China.【Abstract】ObjectiveClinicaldiferencesforpatien~takingexogenouspulmonaryandlungprotectiveventilationinacuterespiratorydistresssyndrometreatmentstrategieswerecompared.MethodsOurhospitaldiagnosed86casesofpatientswithacuterespira6、torydistresssyndrome,accordingtotl1eprimary,secondarydividedintotwogroups:thelungsofacuterespiratorydistresssyndromegroup(ARDSpgroup)andextrapulmonaryacuterespiratorydistresssyndromegroup(ARDSexpgroup).Twogroupsofpatientswithrespiratorymechanics,bloo7、dgasanalysis,theaveragetimeontheventilatorandhospitalstaywerecompared.ResultsAfterlungprotectiveventilationstrategywithin30secondsPIP,Pplat,Pmweresignificantlyincreased(P<0.05):30secondsafterlungprotectiveventilationstrategies,5minutes,15minutes,30mi8、nutesARDSpgroupandARDSexplungCrsweresignifcantlyincreased,thetwogroups,thegroupincreasedARDSexpmoresignificant(P
3、SaO2,PaO,PaO2/Fi0均增高(P<0.05),两组比较ARDSexP组增高更显著(P<0.05);PaCO2复张前后无明显变化(P>0.05)。两组机械通气时间比较差异无统计学意义(P>0.05)。两组住院时间比较差异无统计学意义(P>O.05)。结论对于ARDS患者应用肺保护性策略进行治疗,能够改善患者的氧合,提高抢救成功率,改善患者的预后,对于肺外源性急性呼吸窘迫综合征治疗的效果明显优于肺内急性呼吸窘迫综合征。【关键词】肺保护性通气策略;肺内急性呼吸窘迫综合征;肺外源性急性呼吸窘
4、迫综合征Lungprotectiveventilationstra~iesinthelungsandpulmonaryexogenousclinicalcomparisonofacuterespiratorydistresssyndromeYUANQing-fie,LILian-di.HospitalafiliatedofQingdaouniversitymedicalcolegeintensivemedicine,shandongweifanghan~ngdistrictpeople'shos
5、piml,Qingdao266003,China.【Abstract】ObjectiveClinicaldiferencesforpatien~takingexogenouspulmonaryandlungprotectiveventilationinacuterespiratorydistresssyndrometreatmentstrategieswerecompared.MethodsOurhospitaldiagnosed86casesofpatientswithacuterespira
6、torydistresssyndrome,accordingtotl1eprimary,secondarydividedintotwogroups:thelungsofacuterespiratorydistresssyndromegroup(ARDSpgroup)andextrapulmonaryacuterespiratorydistresssyndromegroup(ARDSexpgroup).Twogroupsofpatientswithrespiratorymechanics,bloo
7、dgasanalysis,theaveragetimeontheventilatorandhospitalstaywerecompared.ResultsAfterlungprotectiveventilationstrategywithin30secondsPIP,Pplat,Pmweresignificantlyincreased(P<0.05):30secondsafterlungprotectiveventilationstrategies,5minutes,15minutes,30mi
8、nutesARDSpgroupandARDSexplungCrsweresignifcantlyincreased,thetwogroups,thegroupincreasedARDSexpmoresignificant(P
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