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目的 :探讨对严重的氧合障碍患者当常规机械通气无效时 ,临床上进一步改善氧合的几种方法 ,以延缓多器官功能衰竭的进展。方法 :6例严重氧合障碍患者并有多器官功能不全或衰竭 ,经常规机械通气 4 8h以上 ,氧合指数仍少于 5 1± 6 .4 ,其中 4例在常规通气下给予 15 ppm浓度的NO吸入治疗 ,2例给予高频震荡通气治疗。结果 :吸入NO的 4例患者在吸入前氧饱和度为 82 .7± 3.96 ,吸入NO后氧饱和度为 87.7± 2 .94 ,起效时间在 10至 15min。使用高频震荡通气的患者氧合指数从 5 7± 4 .2最高升至 97± 4 .2。结论 :严重的氧合障碍患者当常规机械通气无效时 ,可试用NO的吸入或高频震荡通气治疗 ,后者有更高的疗效和安全性
OBJECTIVE: To explore several ways to further improve oxygenation in patients with severe oxygenated disorders when conventional mechanical ventilation is ineffective in order to delay the progression of multiple organ failure. Methods: Six patients with severe oxygenation and multiple organ dysfunction or failure, routine mechanical ventilation more than 48h, the oxygenation index is still less than 5 1 ± 6 .4, of which 4 were given normal ventilation 15 ppm concentration Of NO inhalation therapy, 2 cases given high frequency shock ventilation treatment. Results: Before inhalation, the oxygen saturation of the 4 patients inhaled NO was 82.7 ± 3.96. The oxygen saturation was 87.7 ± 2. 94 after inhalation of NO, and the onset time was 10-15 minutes. Oxygenation index in patients using high-frequency oscillatory ventilation rose from 57 ± 4. 2 up to 97 ± 4 .2. CONCLUSION: Severe oxygenated patients may be treated with NO inhalation or high-frequency oscillatory ventilation when conventional mechanical ventilation is not effective, the latter with higher efficacy and safety