论文部分内容阅读
目的探讨三种不同的肺复张方法(RM)应用于肺内源性急性呼吸窘迫综合征(ARDS)患者的效果和负影响。方法肺内源性急性呼吸窘迫综合征患者40例,按照交叉设计的方法在不同时段分别应用控制性肺膨胀(SI),呼吸末正压递增法(IP),压力控制法(PCV)三种肺复张方法,记录RM前后患者心率,平均动脉压(MAP),中心静脉压(CVP),氧合指数,肺静态顺应性等指标的变化,并作统计学分析。结果RM后患者短时间内氧合指数和肺静态顺应性都明显增加,SI组30 min和1 h增加幅度较其他两组明显减少(P<0.05),2 h时三组数据之间无明显差别(P>0.05)。RM后患者短时间内均有心率增快,CVP上升,MAP下降,SI组变化幅度最大(P<0.05),20 min后三组数据之间无明显差别(P>0.05)。结论对于肺内源性ARDS行RM,SI对肺顺应性和氧合改善效果最差,对血流动力学影响最大,IP和PCV方法没有明显差别。
Objective To investigate the effects and negative effects of three different methods of pulmonary remodeling (RM) on patients with endogenous acute respiratory distress syndrome (ARDS). Methods Forty patients with pulmonary acute respiratory distress syndrome (ARHP) were randomly divided into three groups: control lung expulsion (SI), positive end-expiratory pressure (IP) and pressure control (PCV) Lung recanalization method was used to record changes of heart rate, mean arterial pressure (MAP), central venous pressure (CVP), oxygenation index and pulmonary compliance before and after RM. Statistical analysis was performed. Results After a short period of time, the oxygenation index and static pulmonary compliance of patients in RM group were significantly increased. The increase amplitude of SI group at 30 min and 1 h was significantly lower than that of the other two groups (P <0.05), but there was no significant difference between the two groups Difference (P> 0.05). After RM, heart rate increased rapidly, CVP increased, MAP decreased, and SI group had the largest change (P <0.05). There was no significant difference between the three groups after 20 min (P> 0.05). Conclusions For pulmonary endogenous ARDS with RM, SI has the poorest improvement on pulmonary compliance and oxygenation, and has the greatest effect on hemodynamics. There is no significant difference between IP and PCV methods.