控制性肺膨胀术治疗肺外型急性呼吸窘迫综合征的疗效分析

摘要

Objective:To study clinical effectiveness of sustained inflation (SI)on extrapulmonary acute respiratory disstress syndrome(ARDS).Methods:Twenty-four patients with extrapulmonary ARDS were included from January 2011 to September 2012 .Patients were randomly divided into control group (n=10)and SI group (n=14).Both groups were given lung protec-tive ventilation (LPV),and SI (45 cmH2 O,20 s)was conducted for alveolar recruitment in SI group.Heart rate (HR),mean arterial pressure (MAP),transcutaneous oxygen saturation (SpO2 ),PaO2/FiO2 ,mechanical ventilation time,ICU hospitaliza-tion time were compared between the two groups.Results:SpO2 ,PaO2/FiO2 were increased significantly at 2 h after applying SI in SI group (P <0.05),while there were no significant differences in HR,MAP,mechanical ventilation time,ICU hospitali-zation time between the two groups (P >0.05).No other serious complications were observed.Conclusions:SI can effectively improve oxygenation in patients with extrapulmonary ARDS.It is safe and effective to hemodynamics alveolar recruitment.%目的：评价控制性肺膨胀（sustained inflation ，SI）在肺外型急性呼吸窘迫综合征（acute respiratory distress syndrome， ARDS）的应用效果。方法：选择2011年1月—2012年9月入住延安大学附属医院重症医学科的24例肺外源型 ARDS 患者，随机分为对照组10例，SI 组14例。两组均进行保护性肺通气，SI 组采用 SI（45 cmH2 O，20 s）。比较两组患者的心率（HR）、平均动脉压（MAP）、指末氧饱和度（SpO2）、氧合指数（PaO2／FiO2）、机械通气时间及住 ICU 时间。结果：SI 组患者 SI后2 h，SpO2、PaO2／FiO2较对照组明显增高，差异具有统计学意义（P ＜0．05）；两组 HR、MAP、机械通气时间、住 ICU 时间（P ＞0．05）差异无统计学意义。SI 组无明显并发症出现。结论：SI 能有效改善肺外型 ARDS 患者的氧合能力，对血液动力学影响较小，是安全有效的肺复张方法。