摘要
目的 探讨有创机械通气时不同潮气量对无急性呼吸窘迫综合征(ARDS)的急性呼吸衰竭患者治疗效果的影响。方法 回顾性选取80例无ARDS的急性呼吸衰竭患者,入院治疗时间为2021年11月至2024年4月,入院后全部患者均接受有创机械通气治疗,根据不同的通气潮气量将全部患者分成对照组与研究组,每组各40例;对照组治疗时选择中等潮气量(10ml/kg),研究组治疗时选择小潮气量(6ml/kg)。对两组机械通气治疗48h后的治疗效果进行分析比较。结果 与对照组治疗后相比较,研究组的氧合指数、PaO_(2)水平及肺顺应性更高(P<0.001);PaCO_(2)水平、CRP、IL-6水平及气道峰压更低(P<0.001)。相较于对照组,研究组的机械通气治疗时间、住院时间均更短(P<0.001)。研究组治疗后的心肌性能指数低于对照组,舒张压、收缩压高于对照组(均P<0.001)。研究组的ARDS发生率为5.00%,明显低于对照组的22.50%,差异有统计学意义(P=0.043)。结论无ARDS的急性呼吸衰竭患者在接受有创机械通气治疗时,不同的潮气量对其心功能有一定影响:与小潮气量相比,中等潮气量会导致心室收缩功能降低,对心室舒张功能影响不大;小潮气量治疗可取得显著疗效,并显著改善其预后,使其尽早康复。
Objective To investigate the effect of different tidal volumes during invasive mechanical ventilation on the treatment outcomes of acute respiratory failure patients without acute respiratory distress syndrome(ARDS).Methods A retrospective study was conducted on 80 patients with acute respiratory failure who did not have ARDS.They were admitted for treatment from November 2021 to April 2024.After admission,all patients received invasive mechanical ventilation treatment.According to diff erent ventilation tidal volumes,all patients were divided into a control group and a study group,with 40 patients in each group;The control group chose moderate tidal volume(10ml/kg)for treatment,while the study group chose low tidal volume(6ml/kg)for treatment.Analyze and compare the therapeutic eff ects of two groups of mechanical ventilation treatments after 48 hours.Results Compared with the control group after treatment,the oxygenation index,PaO_(2) level,and lung compliance of the study group were higher(P<0.001);PaCO_(2) levels,CRP,IL-6 levels,and peak airway pressure were lower(P<0.001).Compared with the control group,the study group had shorter mechanical ventilation treatment time and hospitalization time(P<0.001).The myocardial performance index of the research group after treatment was lower than that of the control group,and the diastolic and systolic blood pressure were higher than those of the control group(all P<0.001).The incidence of ARDS in the research group was 5.00%,significantly lower than the 22.50%in the control group,and the diff erence was statistically significant(P=0.043).Conclusion When patients with acute respiratory failure without ARDS receive invasive mechanical ventilation treatment,diff erent tidal volumes have a certain impact on their cardiac function:compared with low tidal volumes,moderate tidal volumes can lead to decreased ventricular systolic function and have little eff ect on ventricular diastolic function;Small tidal volume therapy can achieve significant therapeutic eff ects and significantly improve its prognosis,enabling early recovery.
作者
胡称心
柳逢春
林敏
吴其校
叶章丽
HU ChengXin;LIU Fengchun;LIN Min;WU Qixiao;YE Zhangli(Department of Intensive Care Medicine,Nanping Second Hospital,Nanping 354200,China)
出处
《中华灾害救援医学》
2025年第5期601-605,共5页
Chinese Journal of Disaster Medicine
基金
南平市自然科学基金联合资助项目(N2021J046)。
关键词
潮气量
机械通气
急性呼吸衰竭
Tidal volume
Mechanical ventilation
Acute respiratory failure
