摘要
目的 观察肾上腺糖皮质激素配合无创机械通气治疗严重急性呼吸综合征 (SARS)并发急性呼吸窘迫综合征 (ARDS)的临床疗效。方法 对 36例 SARS并发 ARDS患者应用肾上腺糖皮质激素配合无创机械通气治疗效果进行评价。结果 2 2例治愈 ,其配合 BIPAP呼吸机治疗连续7d以上 ,平均每日治疗时间大于 2 2 h,治疗后 Sp O2 和 Pa O2 显著上升 (P <0 .0 5 ) ,临床症状明显好转 ,气促紫绀减轻 ,呼吸频率减慢 ,心率减慢。14例死亡。结论 早期足量使用肾上腺糖皮质激素配合无创机械通气对于支持 SARS并发 ARDS患者的呼吸功能十分必要。其能减轻呼吸肌疲劳 ,促使呼吸频率减慢 ,改善肺泡通气 ,有效地纠正低氧血症及 ARDS,促进炎症快速吸收 ,降低病死率 ,提高治愈率。进行无创正压机械通气治疗无效者 。
Objective To observe the clinical effect of adrenocorticosteroid (methylprednisolo- ne) with non-invasive positive-pressure machine ventilation on SARS patients with ARDS. Methods 36 SARS patients complicated with ARDS were treated by adrenocorticosteroid combined with non-invasive positive-pressure machine ventilation in our hospital from March June in 2003, and then the effect was evaluated. Results 22 patients were cured, to whom BIPAP respironics were used successively for more than 7 days and more than 22 hours per day averagely. After treatment, SpO 2 and PaO 2 ascended significantly (P<0.05) and clinical symptoms were improved to a certain degree. Respiration rate and heart rate got slower. 14 patients died. Conclusions It is necessary for SARS patients with ARDS to use enough adrenocorticosteroid and non-invasive positive-pressure machine ventilation early to backup theirs respiratory function, by which respiratory muscle were relax, respiration rate got slower, promoted the absorption of inflammation, lowing death rate. It is necessary to perform invasive continuous mechanical ventilation, especially when non-invasive positive-pressure machine ventilation were of little effect. Mechanical ventilation can relieve the fatigue of respiratory muscle, slow down the breathing frequency, improve alveolar ventilation, correct the hypoxia and ARDS, reduce the mortality and improve healing.
出处
《疾病控制杂志》
2004年第1期33-35,共3页
Chinese Journal of Disease Control and Prevention
