机械通气配伍山莨菪碱对高海拔地区ARDS病人的治疗

Clinical therapeutic effect of the low tidal volume mechanical ventilation with PEEP matching anisodamine on ARDS patients at high altitude

目的研究小潮气量+PEEP机械通气配伍山莨菪碱治疗高海拔地区急性呼吸窘迫综合征(ARDS)的临床疗效。方法收集我院确诊的ARDS患者54例,随机分治疗组30例和对照组24例,治疗组采用小潮气量+PEEP机械通气配伍山莨菪碱治疗。对照组用传统小潮气量+PEEP机械通气治疗。结果治疗组PaO2(91.80±2.31)mmHg,较对照组(83.93±1.40)mmHg在通气24小时时明显升高(P<0.001);病死率明显下降(P<0.05);通气时间明显缩短(P<0.05)。结论小潮气量+PEEP机械通气配伍山莨菪碱治疗高海拔地区ARDS较传统方法明显降低病死率。

Objective To study the clinical therapeutic effect of the low tidal volume mechanical ventilation with PEEP matching anisodamine on ARDS patients at high altitude. Methods Fifty-four ARDS patients received mechanical ventilation with PEEP chosen by two means. The treatment group（ n = 30） were chosen by low tidal volume mechanical ventilation with PEEP matching anisodamine on ARDS patients. The control group（ n = 24） were chosen by traditional means with PEEP. The arterial blood gases indexes were detected at the 24 hours after the start of mechanical ventilation. The disease mortality of two groups was calculated and the complication was compared. Results Compared with the control group, the disease mortality in treatment group decreased more remarkably（P 〈 0.05）. Arterial blood oxygenation was obviously increased after mechanical ventilation at 24 hours,partial pressure of oxygenation in artery （ PaO2 ） increased more notably （ P 〈 0. 001） , and the mechanical time shortened （ P 〈0.05 ）. Conclusion The treatment of the low tidal volume mechanical ventilation with PEEP matching anisodamine on ARDS patients can reduce the mortality rate more remarkably than the traditional means at high altitude.