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肺复张对纠正心脏术后低氧血症的临床观察 被引量:1

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摘要 目的探讨肺复张手法对纠正心脏术后低氧血症的可行性并评价其治疗效果。方法心脏术后接受机械通气的低氧血症患者78例,随机分为治疗组与对照组各39例。对照组常规机械通气,治疗组选择呼吸模式、潮气量、呼气末正压同对照组,在此基础上采取肺复张治疗,并对2组氧合结果进行比较。结果治疗组肺复张治疗后血氧饱和度(SaO_2)明显改善(P<0.01),动脉血氧分压(PaO_2)较对照组增高(P<0.05),2组动脉血二氧化碳分压(PaCO_2)、pH值差异均无统计学意义(P>0.05);治疗组呼吸机治疗时间、感染机会、住ICU时间、平均住院时间及并发症发生均优于对照组(均P<0.01)。结论心脏术后尽早应用肺复张治疗可明显纠正低氧血症,改善预后。
作者 刘彬 许卫江
出处 《中国医药》 2007年第8期478-479,共2页 China Medicine
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参考文献8

  • 1Asimakopoulos G;Smith PL;Ratnatunga CP.Lung injury and acute respiratory distress syndrome after cardiopulmonary bypass,1999(03).
  • 2Canel J;Ricoa M;Vidal F.Early postoperative arterial oxygen desat2urstion deteriorating factors and response to oxygen therapy,1989(02).
  • 3王书鹏,秦英智.急性呼吸窘迫综合征肺复张策略的研究进展[J].中国危重病急救医学,2005,17(8):509-511. 被引量:39
  • 4Christenson JT;Aeberhard JM;Badel P.Adult respiratory distress syndrome after cardiac surgery,1996(01).
  • 5GuUJ;MarianiMA;Van Ocvcrcn W.Rcduction of the Inflammatory response einpatients undergoing minimally invasive coronary artery by pass grafting,1998(12).
  • 6曾因明;孙大金.重症监测治疗与复苏,1996.
  • 7张贞雄,谢立刚,刘进.冠脉搭桥术后低氧血症发生率调查与原因分析[J].山东医药,2001,41(2):9-10. 被引量:11
  • 8Russell GB;Graybal JM.Hypoxemic episodes of patients in a postanesthesia care unit[J],1993(03).

二级参考文献22

  • 1刘大为.急性呼吸窘迫综合征的机械通气策略——由通气不均一向均一性的转变[J].中国危重病急救医学,2004,16(7):385-386. 被引量:38
  • 2邱海波,许红阳,杨毅,周韶霞,陈永铭,孙辉明.呼气末正压对急性呼吸窘迫综合征肺复张容积及氧合影响的临床研究[J].中国危重病急救医学,2004,16(7):399-402. 被引量:56
  • 3徐磊,王书鹏,秦英智,张纳新.绵羊急性呼吸窘迫综合征开放肺压力安全性的实验研究[J].中国危重病急救医学,2005,17(8):468-471. 被引量:18
  • 4龙村.体外循环手册(第1版)[M].北京:人民卫生出版社,1997.251-252.
  • 5Anton H,Anne de J,Jack J,et al.Positive pressure ventilation with the open lung concept optimizes gas exchange and reduces ventilator-induced lung injury in newborn piglets[J].Pediatric Research,2003,53:245-253.
  • 6Keith G.Reinterpreting the pressure-volume curve in patients with acute respiratory distress syndrome[J].Critical Care,2002,8:32-38.
  • 7Lapinsky S E,Aubin M,Mehta S,et al.Safety and efficacy of a sustained inflation for alveolar recruitment in adult with respiratory failure[J].Intensive Care Med,1999,25:1297-1301.
  • 8Villagra B A,Ochagavia A,Vatua S,et al.Recruitment maneuvers during lung protective ventilation in acute respiratory distress syndrome[J].Br J Anaesth,2001,80:360-364.
  • 9Peter C,Peter N,Helena F,et al.The open lung during small tidal volume ventilation:concepts of recruitment and "optimal" positive end-expiratory pressure[J].Crit Care Med,1999,27:1946-1952.
  • 10Thomas E,Van der Kloot,Lluis B,et al.Recruitment maneuvers in three experimental models of acute lung injury[J].Am J Respir Crit Care Med,2000,161:1485-1494.

共引文献48

同被引文献28

  • 1王书鹏,秦英智.急性呼吸窘迫综合征肺复张策略的研究进展[J].中国危重病急救医学,2005,17(8):509-511. 被引量:39
  • 2Gale GD,Teasdale SJ,Sanders DE. Pulmonary atelectasis and other respiratory complications after cardiopulmonary bypass and investigation of aetiological factors[J].CANADIAN ANAESTHETISTS SOCIETY JOURNAL,1979,(01):15-21.
  • 3Schell DN,Winlaw DS. Peri-operative management of paediatric patients undergoing cardiac surgery-focus on respiratory aspects of care[J].Paediatric Respiratory Reviews,2007,(04):336-347.
  • 4Lachmann B. Open up the lung and keep the lung open[J].Intensive Care Medicine,1992,(06):319-321.
  • 5Letsiou E,Kitsiouli E,Nakos G. Mild stretch activates cPLA(2) in alveolar type II epithelial cells independently through the MEK/ ERK and PI3K pathways[J].Biochimica Et Biophysica Acta,2011,(06):370-376.
  • 6van Kaam A,Haitsma J,De Jaegere A. Open lung ventilation improves gas exchange and attenuates secondary lung injury in a piglet model of meconium aspiration[J].Critical Care Medicine,2004,(02):443-449.doi:10.1097/01.CCM.0000104952.61111.49.
  • 7Nielsen J,Ostergaard M,Kjaergaard J. Lung recruitment maneuver depresses central hemodynamics in patients following cardiac surgery[J].Intensive Care Medicine,2005,(09):1189-1194.doi:10.1007/s00134-005-2732-z.
  • 8Kim JT,Na HS,Kim HS. CPAP of 10 cmH2O during cardiopulmonary bypass followed by an alveolar recruitment manoeuvre does not improve post-bypass oxygenation compared to a recruitment manoeuvre alone in children[J].Anaesthesia and Intensive Care,2010,(02):291-294.
  • 9Miranda D,Struijs A,Koetsier P. Open lung ventilation improves functional residual capacity after extubation in cardiac surgery[J].Critical Care Medicine,2005,(10):2253-2258.
  • 10Miranda DR,Gommers D,Struijs A. Ventilation according to the open lung concept attenuates pulmonary inflammatory response in cardiac surgery[J].European Journal of Cardio-Thoracic Surgery,2005,(06):889-895.doi:10.1016/j.ejcts.2005.10.007.

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