压力控制法肺复张在急性呼吸窘迫综合征中的应用

The Use of Pressure-controlled Recruitment Maneuver in Patients with Acute Respiratory Distress Syndrome

机械通气是急性呼吸窘迫综合征(ARDS)的主要治疗手段,肺复张手法应用较高压力开放塌陷肺泡,并使用高呼吸末正压防止肺泡塌陷,期望恢复肺泡的同一性,减少呼吸机相关性肺损伤,改善患者预后。但近年的临床试验却得出矛盾的结果,其有效性及安全性及具体实施方法仍无统一意见。现就压力控制法肺复张在ARDS中的有效性、安全性的操作方法予以综述。

Mechanical ventilation is the major treatment for patients with acute respiratory distress syndrome（ARDS）.Recruitment maneuvers that use high transpulmonary pressure to reopen atelectatic alveoli and employ high end-expiratory pressure to prevent alveolar collapse,with the expectation to reconstruct the alveolar homogeneity,reduce the ventilation-associated pulmonary injuries,and improve the prognosis of patients.However,the recent clinical studies show controversial results,remaining controversial in the effectiveness,safety,and protocol.This article reviews the effectiveness and safe practice of pressure-controlled recruitment maneuver.