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目的:观察控制性肺膨胀(SI)对肺部疾患、肺外疾患引起的急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)患者的疗效。方法:60例ALI/ARDS患者按病因不同分为两组,每组30例。A组:肺部疾患导致ALI/ARDS(primarily from pulmonary diseases,ARDSp)。B组:肺外疾患导致ALI/ARDS(primarily from extra-pulmo-nary diseases,ARDSexp)。均在常规治疗基础上予呼吸机辅助呼吸,实行肺保护性通气,如指氧饱和度(SpO2)低于90%,予控制性肺膨胀治疗,于治疗前后监测气道平台压(Pplat)、吸入峰压(Ppeak)、平均气道压(Pmean)、呼吸系统顺应性(Crs)、气道阻力(R)、心率(HR)、中心静脉压(CVP)、平均动脉压(MAP)及动脉血气分析。结果:B组PaO2、SpO2的改善均明显优于A组(P<0.05)。结论:肺外源性的ALI/ARDS对SI的反应优于肺内源性的ALI/ARDS。
Objective: To observe the effect of controlled lung expansion (SI) on patients with acute lung injury / acute respiratory distress syndrome (ALI / ARDS) caused by pulmonary diseases and extrapulmonary diseases. Methods: Sixty patients with ALI / ARDS were divided into two groups according to different etiologies, with 30 cases in each group. Group A: Pulmonary disorders lead to ALI / ARDS (ARDSp). Group B: Extrapulmonary conditions lead to ALI / ARDS (ARDSexp). Ventilator assisted breathing was performed on the basis of routine treatment. Lung protective ventilation was performed. For example, oxygen saturation (SpO2) was less than 90%, control lung expansion was treated, airway pressure (Pplat) was monitored before and after treatment, Ppeak, Pmean, Crs, R, HR, CVP, MAP, and arterial pressure Blood gas analysis. Results: The improvement of PaO2 and SpO2 in group B was significantly better than that in group A (P <0.05). CONCLUSIONS: The response of lung-derived ALI / ARDS to SI is superior to that of lung-derived ALI / ARDS.