肺复张和保护性肺通气在急性肺损伤救治中的护理

摘要

目的 探讨肺复张联合保护性肺通气策略治疗急性肺损伤患者的疗效及护理.方法 对42例急性肺损伤/急性呼吸窘迫综合征(ALI/ARDS)患者均采用保护性机械通气,并联合肺复张手法,给予35 cmH2O的气道压力,持续30 s后,恢复原通气模式及条件.结果 31例患者成功撤机,临床症状明显好转,治愈出院,成功率73.8％.死亡11例,病死率26.2％.结论 肺复张和保护性肺通气策略是治疗急性肺损伤的主要手段.做好保护性机械通气期间的护理及严密监测是治疗成功的关键.%Objective To investigate the effects of lung recruitment (RM) maneuvers in combination with lung protective ventilation strategy in the acute lung injury patients. Methods Forty- two patients who had acute lung injury/acute respiratory distress syndrome (ALI/ARCS) were all given protective ventilation, every 8 hours, and all patients were given 30 seconds of RM to open the lung units, the optimal inspiratory pressure being 35 cmH 2O. Results Thirty -one patients improved, and the effective rate was 73.8%. Eleven patients died and the mortality was 26. 2%. Conclusion RM in combination with lung protective ventilation is an effective treatment for acute lung injury.