急性呼吸窘迫综合征患者肺胸动态顺应性与氧合指数对照观察

A comparsive research on pulmonary dynamic compliance and oxygenation index in patients with acute respiratory distress syndrome

目的 探讨急性呼吸窘迫综合征 (ARDS)患者肺胸动态顺应性 (CD)与氧合指数的相关性及其意义。方法 ARDS患者诊断明确后行机械通气 ,隔日观测取值一次 ;观测前充分镇静 ,先查动脉血气 ,然后设定气道压力上限至 40cmH2 O(呼吸机其它参数不变 ) ,手控送气 ,记录肺通气量 ,反复 5次取平均值 ,作为当次观测的潮气量值 ,再计算出CD值。结果 ARDS患者治愈组随肺胸动态顺应性升高氧合指数升高 ,两者呈显著正相关 (r =0 992 ,P <0 0 0 1 ) ;死亡组随肺胸动态顺应性及氧合指数均降低 ,两者亦呈显著正相关 (r =0 993 ,P <0 0 0 1 )。结论 ARDS患者肺功能改善 ,氧合指数和CD亦升高 ;随着肺损伤加重 ,氧合指数和CD亦降低 ,二者结合可评估ARDS患者治疗过程中的肺功能状态 。

Objective To investigate correlation between oxygenation index and pulmonary dynamic compliance (C D ) in patients with acute respiratory distress syndrome(ARDS) and its significance Methods Value of oxygenation index and C D were monitored every other day after diagnosis of ARDS was ascertained and mechanical ventilation was performed Before monitoring procedure arterial blood gas analysis was taken,then an airway pressure of 40 cm H 2 O was set during which other ventilator parameters unchanged While manual control ventilation was set, value of C D was calculated based on average ventilation volume Results In cured patients oxygenation index was elevated as pulmonary dynamic compliance was improved with a significant correlation between these two parameters( r =0 9992, P <0 001) In the dead from ARDS,oxygenation index was decreased along with decreased pulmonary dynamic compliance Conclusion C D is a determinant factor influencing oxygenation indexes in patients with ARDS,which could be regarded as a index of pulmonary function improvement and better therapy responsiveness, predicting the outcome of the patients