不同機械通氣方式治療急性呼吸窘迫綜合癥療效對比

宋靜+王征+鄧琳瑕

[摘要] 目的 探討肺外性急性呼吸窘迫綜合癥（ARDSexp）治療中，應(yīng)用呼氣末正壓遞增（PI）和持續(xù)氣道正壓（CPAP）兩種不同機械通氣方式的臨床治療效果。 方法 將2013年1月—2013年12月期間該科收治的52例ARDSexp患者隨機分為接受PI方式機械通氣治療（PI組）及受CPAP方式機械通氣治療（CPAP組）兩組，每組26例。分析兩組臨床治療效果。結(jié)果 兩組在接受機械通氣前，血氣分析（PaO2、PaCO2、PaO2/FiO2）、心率（HR）、收縮壓（SBP）及舒張壓（DBP）比較未見統(tǒng)計學差異（P>0.05），經(jīng)治療后15 min后兩組PaO2及PaO2/FiO2顯著提高（P<0.05），并可維持至3 h（P<0.05）。兩組間比較未見統(tǒng)計學差異（P>0.05）。兩組PaCO2治療前后比較未見統(tǒng)計學差異。但兩組治療15 min及治療3 h與治療前HR、SBP及DBP比較未見統(tǒng)計學差異（P>0.05），且兩組治療15 min及治療3 h比較未見統(tǒng)計學差異（P>0.05）。結(jié)論 ARDSexp患者應(yīng)用PI及CPAP兩種機械通氣方式均有著較好的臨床治療效果。

[關(guān)鍵詞] 肺外性急性呼吸窘迫綜合癥；呼氣末正壓遞增；持續(xù)氣道正壓

[中圖分類號] R563.8 [文獻標識碼] A [文章編號] 1674-0742（2015）02（b）-0008-03

Comparison of the Effect Between Different Mechanical Ventilation Modes in the Treatment of Acute Respiratory Distress Syndrome

SONG Jing1 WANG Zheng2 DENG Linxia1

1.Department of Geriatrics， Dalian Friendship Hospital， Dalian， Liaoning Province， 116001 China

2.Department of Emergency， Dalian Friendship Hospital， Dalian， Liaoning Province， 116001 China

[Abstract] Objective To investigate the clinical effect of positive end-expiratory pressure increasing （PI） and continuous positive airway pressure（CPAP） these two different modes of mechanical ventilation in the treatment of extrapulmonary acute respiratory distress syndrome（ARDSexp）. Methods Fifty-two cases with ARDSexp admitted to the hospital from January 2013 to December 2013 were randomly divided into PI group treated by PI mode mechanical ventilation， and the CPAP group treated by CPAP with 26 cases in each. And the clinical effects of the two groups were analyzed. Results Before receiving mechanical ventilation， there were no statistically significant differences between blood gas analysis（PaO2， PaCO2， PaO2/FiO2）， heart rate（HR）， systolic blood pressure（SBP） and diastolic blood pressure （DBP） between the two groups（P>0.05）. 15 minutes after treatment， the levels of PaO2， PaO2/FiO2 of both groups increased significantly（P<0.05）， and which could keep for 3 hours （P<0.05）； and the differences between the two groups were not statistically significant（P>0.05）. The difference in the level of PaCO2 of the two groups before and after treatment was not statistically significant. No statistically significant differences were found in HR， SBP and DBP before treatment and 15 minutes and 3 hours after treatment in both groups（P>0.05）， and the differences in those 15 minutes and 3 hours after treatment between the two groups were not statistically significant（P>0.05）. Conclusion Both PI and CPAP mechanical ventilation modes have good clinical effect on patients with ARDSexp.