术后并发急性呼吸窘迫综合征的呼吸支持

Respiratory support for patients with acute respiratory distress syndrome after surgery

目的评价呼吸机在手术后并发急性呼吸窘迫综合征(ARDS)的治疗效果。方法回顾性分析42例手术后并发ARDS且应用呼吸机治疗患者的临床资料。结果ARDS发生时间为术后16h～8d;8例仅应用面罩通气,4～13(6.3±0.7)d痊愈出院;15例因面罩通气疗效欠佳而改气管插管或切开有创通气,呼吸机使用6～17(9.3±0.7)d,3例死于多器官功能障碍综合征;19例早期即有创通气者,呼吸机使用3～8(5.1±0.4)d,均痊愈出院。结论早期即进行有创机械通气治疗可显著缩短呼吸机使用时间,提高治愈率。

Objective To summarize the outcomes of respiratory support for patients with acute respiratory distress syndrome（ARDS） after surgery. Methods The data of 42 patients with ARDS after surgery were analyzed retrospectively. Results The ARDS-diagnosed time was 16 h-8 d after surgery. The respiration was supported with facemask ventilation 4-13 （6.3±0.7） d in 8 patients only, who were cured completely, and with mechanical ventilation via tracheal intubation or tracheotomy in 34 cases, of whom three cases died from multiple organ failure. Conclusion Early respiratory support can shorten the time of mechanical ventilation and improve the cure rate in patients with ARDS after surgery.