摘要
目的探讨膈肌保护性通气序贯肺复张治疗对中重度急性呼吸窘迫综合征(ARDS)患者动脉血气的影响。方法选取2022年1月至2024年6月在我院就诊的70例中重度ARDS患者,随机分为观察组和对照组,每组35例。观察组采用膈肌保护性通气序贯肺复张治疗,对照组采用常规肺保护性通气治疗,比较两组患者的临床结局指标、治疗前和治疗后血气分析参数以及血流动力学指标。结果治疗后,观察组机械通气时间及重症监护病房(ICU)住院时间均显著少于对照组,呼吸机相关性肺炎(VAP)累计发病率及全因死亡率均低于对照组(P<0.05)。治疗后,两组动脉血氧分压(PaO_(2))、氧合指数(PaO_(2)/FiO_(2))较治疗前明显升高,动脉血二氧化碳分压(PaCO_(2))较治疗前下降,且观察组改善幅度更显著(P<0.05)。治疗后,两组平均动脉压(MAP)、中心静脉压(CVP)均较同组治疗前显著改善,且观察组MAP与CVP优于对照组(P<0.05)。结论中重度ARDS患者采用膈肌保护性通气序贯肺复张治疗在改善动脉血气指标、优化临床结局及稳定血流动力学方面效果显著,为临床治疗提供了一种更优的通气策略。
Objective To investigate the effect of diaphragm protective ventilation sequential lung recruitment therapy on arterial blood gas in patients with moderate to severe acute respiratory distress syndrome(ARDS).Methods A total of 70 patients with moderate to severe ARDS who were treated in our hospital from January 2022 to June 2024 were randomly divided into observation group and control group,with 35 cases in each group.The observation group was treated with diaphragm protective ventilation sequential lung recruitment therapy,and the control group was treated with conventional lung protective ventilation therapy.The clinical outcome indexes,blood gas analysis parameters and hemodynamic indexes before and after treatment were compared between the two groups.Results After treatment,the mechanical ventilation time and intensive care unit(ICU)hospitalization time in the observation group were significantly less than those in the control group,and the cumulative incidence of ventilator-associated pneumonia(VAP)and all-cause mortality were lower than those in the control group(P<0.05).After treatment,the arterial partial pressure of oxygen(PaO_(2))and oxygenation index(PaO_(2)/FiO_(2))in the two groups were significantly higher than those before treatment,and the arterial partial pressure of carbon dioxide(PaCO_(2))was lower than that before treatment,and the improvement in the observation group was more significant(P<0.05).After treatment,the mean arterial pressure(MAP)and central venous pressure(CVP)in two groups were significantly improved than those in the same group before treatment,and MAP and CVP in the observation group were better than those in the control group(P<0.05).Conclusion In patients with moderate to severe ARDS,the use of diaphragm protective ventilation sequential lung recruitment therapy has a significant effect on improving arterial blood gas indicators,optimizing clinical outcomes and stabilizing hemodynamics.It provides a better ventilation strategy for clinical treatment.
作者
顾斌
吴丽芳
葛勤中
陈丽菊
GU Bin;WU Lifang;GE Qinzhong(Department of Critical Care Medicine,Kunshan Third People's Hospital,Kunshan,Jiangsu 215300,China;不详)
出处
《医师在线》
2025年第12期51-54,共4页
Journal of Doctors Online
基金
2023年昆山市级科技专项(KS2334)。
关键词
急性呼吸窘迫综合征
膈肌保护性通气序贯肺复张
动脉血气
Acute respiratory distress syndrome
Diaphragm protective ventilation sequential lung recruitment
Arterial blood gas
