摘要
目的探讨急性呼吸窘迫综合症(ARDS)患者的诱发因素、死亡原因以及在呼吸机支持治疗中生命体征监测对病情转归的临床意义。方法对兰州军区兰州总医院R ICU收治的20例ARDS的进行分析。结果死亡组与存活组比较总机械通气天数差异显著(P=0.015);存活组中吸氧浓度、血氧饱和度、呼吸频率、心率在带机前后差异显著(P<0.05);死亡组中显示死亡前吸氧浓度较带机前明显升高(P<0.01),与存活组脱机前吸氧浓度有显著差异(P<0.01),死亡组中吸氧浓度、血氧饱和度、心率在带机前和死亡前有显著的差异(P<0.05)。结论ARDS诱发因素主要为肺部感染和脓毒症;MODS是患者死亡的主要原因;有创呼吸机治疗是维持生命体征的主要方法,在维持有效的血压、动脉血氧分压的情况下,吸氧浓度、血氧饱和度、呼吸频率、心率是监测患者是否能够成功脱机的有效而便捷的指标。
Objectives To probe into the etiology of acute respiratory distress syndrome （ ARDS）, the causes of death and the clinical significance of life symptom monitor during mecbanical ventilation. Methods A retrospective analysis of 20 patients with ARDS in RICU was carried out. The patients were divided into survivor group and death group, and the data collected were the variables of age, sex, biochemical indicator, blood gas analysis, ICU length of stay, presence or absence of tracteostomy, length of ventilation, ventilation and so on. Results Between the survivor group and the death group there was a significant difference in the time length of ventilation （P = 0. 015 ）. In the survivor group, there was a significant difference in the level of FiO2, SaO2, resperation rate （RR） and heart rate （HR） before and after the using of mechanical ventilation （ P 〈 0. 05 ）. In the death group, there was an obvious increase in FiO2 （ P 〈 0.01 ） in the patients before they died, compared with the patients＇state without the mechanical ventilation. Conclusion The treatment with mechanical ventilation is the crucial method in sustaining life symptom. FiO2 , SaO2, RR and HR are the effective and handy as clinical signs to the patients with mechanical ventilation under the state of maintaining BP and PaO2.
出处
《临床肺科杂志》
2010年第4期456-458,共3页
Journal of Clinical Pulmonary Medicine
基金
全军医药科研基金项目(06G029)
关键词
急性呼吸窘迫综合症
机械电子
多功能衰竭
acute respiratory distress syndrome （ARDS）
mechanical ventilation
multiple organ dysfunction score （MODS）
