呼吸窘迫综合征应用肺保护性通气策略的疗效观察
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摘要
目的:探讨肺保护性通气策略应用于呼吸窘迫综合征的临床疗效,以期为进一步增强患者肺保护提供参考。方法:选择某院收治的95例呼吸窘迫综合征患者的临床资料进行回顾性分析,按照治疗方案的不同将患者分为对照组(33例)与观察组(62例),对照组采用传统机械通气策略治疗,观察组采用肺保护性通气策略治疗。对2组患者临床总有效率及治疗前后血气指标及血流动力学的变化情况进行对比分析。结果:临床治疗总有效率,观察组高于对照组,差异有统计学意义(P <0. 05); 2组患者治疗后氧合指数均明显升高,且观察组高于对照组(P <0. 05),pH值及静脉血氧分压差异无统计学意义(P>0. 05);观察组患者心率,血乳酸,Pa O_2,Pa CO_2等指标均优于对照组,2组比较差异有统计学意义(P <0. 05)。结论:将肺保护性通气策略应用于呼吸窘迫综合征的治疗中可取得较传统机械通气策略更好的临床疗效,能有效改善患者的血流动力学及血气指标,值得推广。
Objective: To analyze the effect of lung protective ventilation strategy on respiratory distress syndrome( RDS) in order to provide reference for further lung protection of patients with RDS. Methods: Clinical data of 95 patients with RDS were retrospectively analyzed. The patients were divided into a control group( 33 cases) and an observation group( 62 cases) according to different treatment plans. The control group was treated with traditional mechanical ventilation strategy,and the observation group was treated with lung protective ventilation strategy. Total effective rate,blood gas index and hemodynamics before and after the treatment were analyzed and compared between the two groups. Results: In comparison with the control group,the total effective rate of clinical treatment in the observation group was significantly higher than that in the control group( P < 0. 05). After the treatment,the oxygenation index of the two groups remarkably increased,with the observation group's significantly higher than that of the control group( P < 0. 05). There was no statistical difference in PH value and partial venous oxygen pressure between the two groups( P > 0. 05). Indexes such as HR,BLa,Pa O_2 and Pa CO_2 of the observation group were significantly better than those of the control group( P < 0. 05). Conclusion: The application of lung protective ventilation strategy in treatment of RDS can achieve a better clinical effect than the traditional mechanical ventilation one. It can effectively improve the blood gas index and hemodynamics of patients. It is worth popularizing.
Objective: To analyze the effect of lung protective ventilation strategy on respiratory distress syndrome( RDS) in order to provide reference for further lung protection of patients with RDS. Methods: Clinical data of 95 patients with RDS were retrospectively analyzed. The patients were divided into a control group( 33 cases) and an observation group( 62 cases) according to different treatment plans. The control group was treated with traditional mechanical ventilation strategy,and the observation group was treated with lung protective ventilation strategy. Total effective rate,blood gas index and hemodynamics before and after the treatment were analyzed and compared between the two groups. Results: In comparison with the control group,the total effective rate of clinical treatment in the observation group was significantly higher than that in the control group( P < 0. 05). After the treatment,the oxygenation index of the two groups remarkably increased,with the observation group's significantly higher than that of the control group( P < 0. 05). There was no statistical difference in PH value and partial venous oxygen pressure between the two groups( P > 0. 05). Indexes such as HR,BLa,Pa O_2 and Pa CO_2 of the observation group were significantly better than those of the control group( P < 0. 05). Conclusion: The application of lung protective ventilation strategy in treatment of RDS can achieve a better clinical effect than the traditional mechanical ventilation one. It can effectively improve the blood gas index and hemodynamics of patients. It is worth popularizing.
引文
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[8]王彦军,赵威,张松涛,等.小潮气量联合低平台压在急性呼吸窘迫综合征患者机械通气中的应用[J].临床急诊杂志,2017,18(3):200-203.
[2]喻文亮.急性呼吸窘迫综合征的肺保护性通气治疗现状和再认识[J].中华实用儿科临床杂志,2016,31(18):1381-1383.
[3]蔡振刚.探讨打开肺通气策略治疗重症急性呼吸窘迫综合征的临床价值[J].世界中医药,2016,11(b6):2125-2126.
[4]熊伟,陈萍.肺保护通气策略在全身麻醉术中的研究进展[J].医学综述,2016,22(5):921-924.
[5]谭华,吴畏.肺保护性通气策略研究进展[J].西南国防医药,2017,27(2):212-214.
[6]蔡英丽,詹红.呼气末二氧化碳分压联合平台压监测在急性呼吸窘迫综合征机械通气中的应用进展[J].医学综述,2017,23(6):1210-1214.
[7]宋邵华,田惠玉,杨秀芬,等.气道压力释放通气对急性呼吸窘迫综合征患者的临床应用观察[J].中国医刊,2017,52(5):26-30.
[8]王彦军,赵威,张松涛,等.小潮气量联合低平台压在急性呼吸窘迫综合征患者机械通气中的应用[J].临床急诊杂志,2017,18(3):200-203.