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目的:探寻中度高原地区急性呼吸窘迫综合征(ARDS)的氧缺陷类型;方法:对西宁地区海拔(2 260m)32例ARDS患者进行血液动力学及血气分析、测定心排指数(CI)、循环阻力(SVRI)、氧输送(DO)、氧消耗(VO)、氧摄取率(ER)以及临床一般资料进行分析;结果:ARDS血液动力学早期表现为高心排指数、低系统阻力,绝大多数表现高氧耗型氧缺陷,随着病情进展,成活组CI、SVRI趋于正常,死亡组则表现持续高动力循环,氧缺陷表现为低氧供型;病程晚期成活组CI、SVRI、DO、VO正常,死亡组仍呈高动力循环;讨论:DO下降,但不伴ER的代偿性增高,出现低氧供型和病理性氧依赖是ARDS的主要死亡原因。
Objective: To explore the types of oxygen deficiency in acute respiratory distress syndrome (ARDS) in moderate altitude plateau. Methods: Thirty-two ARDS patients in Xining district at an altitude of 2 260 m were subjected to hemodynamics and blood gas analysis. Cardiothoracic index (CI) (SVRI), oxygen delivery (DO), oxygen consumption (VO), oxygen uptake rate (ER) and clinical data were analyzed.Results: Early manifestations of hemodynamics in ARDS were high cardiac index, low systemic resistance, Most of the patients showed high oxygen consumption oxygen deficit. As the disease progressed, survival CI and SVRI tended to be normal, while death group showed sustained hyperdynamic circulation and oxygen deficiency showed hypoxia. DO, VO normal, the death group still showed hyperdynamic circulation; Discussion: DO decreased, but not with compensatory increase of ER, hypoxia and pathological oxygen dependence is the main cause of death in ARDS.