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目的探讨肺泡表面活性物质(PS)对急性呼吸窘迫综合征(ARDS)机械通气危重患者呼吸功能及血流动力学的影响。方法比较40例ARDS机械通气的危重患者使用PS治疗前及治疗24 h后动脉血气、呼吸力学及血流动力学参数的变化。结果 PS治疗后动脉血氧分压(PaO2)、氧合指数(PaO2/FiO2)、动脉血二氧化碳分压(PaCO2)及肺泡动脉血氧分压差(A-aDO2)均较治疗前明显改善(均P<0.05);PS治疗后潮气量(Vt)、气道峰压(Ppeak)、平台压(Ppause)、心率(HR)、中心静脉压(CVP)、平均动脉压(MAP)、右心房压(RAP)、右心室压(RVP)、肺动脉平均压(PAP)、肺毛细血管楔压(PCWP)及心排血量(CO)均较引流前有明显改善(均P<0.05)。结论机械通气ARDS危重患者使用PS治疗可以明显改善通气和换气功能,并使患者的血流动力学趋于稳定。
Objective To investigate the effects of alveolar surfactant (PS) on respiratory function and hemodynamics in critically ill patients with mechanical ventilation of acute respiratory distress syndrome (ARDS). Methods The changes of arterial blood gas, respiration mechanics and hemodynamics in 40 critically ill patients with mechanical ventilation of ARDS before and after treatment with PS were compared. Results PaO2, PaO2 / FiO2, PaCO2 and A-aDO2 in PS group were significantly improved after treatment (P <0.05) (P <0.05). After PS treatment, tidal volume (Vt), Ppeak, Ppause, HR, CVP, MAP, Right ventricular pressure (RAP), right ventricular pressure (RVP), mean pulmonary artery pressure (PAP), pulmonary capillary wedge pressure (PCWP) and cardiac output (CO) were significantly improved compared with those before drainage (all P <0.05). Conclusions The use of PS in critically ill patients with mechanically ventilated ARDS can significantly improve the ventilatory and ventilatory functions and stabilize the patient’s hemodynamics.