高频振荡通气对烟雾吸入性肺损伤致急性呼吸窘迫综合征患者临床疗效及预后的影响被引量：11

The Effects of High Frequency Percussive Ventilation for Patients with ARDS Induced by Smoke Inhalation

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摘要目的通过回顾性分析探究高频振荡通气与常规机械通气对烟雾吸入性肺损伤致急性呼吸窘迫综合征(ARDS)患者的临床疗效,为选择正确的通气模式提供参考。方法收集我院危重病监护中心2004年10月至2015年6月期间烧伤合并烟雾吸入性肺损伤致ARDS患者43例,其中24例接受高频振荡通气治疗(HFOV组),19例接受常规通气治疗(CV组),对比分析两组患者于入院后规定时间点(第6 h、24 h、48 h、96 h、7 d)的血气变化、并发症和预后情况。结果通气治疗前两组患者动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、动脉血氧分压/吸氧浓度比值(PaO_2/FiO_2)差异无统计学意义(P>0.05),通气治疗后除第48 h、96h PaCO_2未见明显差异外(P>0.05),其余规定时点HFOV组各血气指标较CV组改善更明显(P<0.05)。HFOV组患者住院与通气时间较CV组明显缩短(P<0.05)。两组患者死亡率与严重并发症发生率差异均无统计学意义(P>0.05),30天累计生存率提示两组患者生存曲线无显著差异(P>0.05)。结论高频振荡通气与常规通气模式均能改善烟雾吸入性肺损伤致ARDS患者的临床状况,当前研究并不能说明两种通气模式下患者预后具有差异。 Objective To retrospectively compare the clinical effects of high frequency oscillatory ventilation （ HFOV） and conventional ventilation （ CV） on patients with acute respiratory distress syndrome （ ARDS） induced by smoke inhalation injury. Methods Forty-three patients with smoke inhalation induced ARDS were admitted in the Center Hospital of Hu Ludao between October 2004 and June 2015. Among the patients,19 cases were treated with CV （ CV group） and 24 cases were treated with HFOV （ HFOV group） . The clinical data were collected and compared between two groups including blood gas at certain time points （ 6 h, 24 h, 48 h,96 h, and 7 d） as well as complications and prognosis. Results There was no significant difference in arterial blood gas between two groups before treatment （ P 〉0. 05） . After ventilation treatment, there were significant differences in arterial blood gas parameters between two groups except arterial carbon dioxide partial pressure at 48 and 96 h. And the patients in the HFOV group improved more obviously. The hospitalization time and ventilation time in the HFOV group were significantly shorter than those in the CV group （ P 〈 0. 05） . No significant difference was found between two groups in the incidences of mortality, complications or 30-day survival rate （ P 〉0. 05） . Conclusions Both high frequency oscillatory ventilation and conventional ventilation can improve the clinical status in patients with smoke inhalation induced ARDS. These two ventilation modes do not present any difference with respect to prognosis by present evidence.

作者沈锦红韩可兴

机构地区辽宁省葫芦岛市中心医院辽宁医学院第一附属医院

出处《中国呼吸与危重监护杂志》 CAS 北大核心 2016年第1期49-52,共4页 Chinese Journal of Respiratory and Critical Care Medicine

关键词高频振荡通气常频机械通气烟雾吸入性肺损伤急性呼吸窘迫综合征 High frequency oscillatory ventilation Conventional ventilation Smoke inhalation injury Acute respiratory distress syndrome

分类号 R563.8 [医药卫生—呼吸系统]

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参考文献14

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