机械通气联合雾化吸入治疗急性呼吸窘迫综合征的临床应用

Clinical application of treatment for ARDS by connecting Respimat and mechanical ventilation

目的:探讨机械通气联合雾化吸入治疗急性呼吸窘迫综合征(ARDS)的临床效果。方法:重症ARDS患者32例分为机械通气联合雾化吸入治疗组(A组)16例和机械通气治疗组(B组)16例。记录插管前(T0)、插管后10 min(T1)、插管后30 min(T2)、插管后50 min(T3)各时点两组患者HR、SpO2、PETCO2、气道阻力参数和患者一般状况。结果:两组患者一般状况、年龄、性别及T0时HR、SpO2、PETCO2及气道阻力差异均无统计学意义,从T1～T3各项指标渐趋向正常。A组在T1、T2、T3时HR比B组变慢幅度大(P<0.05);在T1时PETCO2 A组比B组升高幅度大(P<0.05);在T1、T2、T3时气道阻力A组比B组降低幅度大(P<0.05)。结论:早期小潮气量机械通气联合雾化吸入治疗ARDS患者有助于减少肺损伤和加速肺水肿消散,改善预后,比单独机械通气治疗有明显临床优势。

Objective To analyze the clinical effects of the treatment for ARDS by connecting Respimat and mechanical ventilation.Method For 32 severe ARDS cases which were rescued successfully in our hospital,including 16 cases in group A（treatment of connecting Respimat and mechanical ventilation） and 16 cases in group B（treatment of mechanical ventilation）.For each group,keep record on airway resistance parameters and patients′ normal status in certain moment of intubation,before intubation（T0） and 10 min（T1）,30 min（T2）,50 min（T3） after intubation.Results The differences of the two groups in the patients′ normal status,age,and gender were not statistically significant,each index from T1～T3 intended to normal.HR of T1,T2 and T3 in group A had a larger slower amplitude than in group B（P0.05）;the rising of PETCO2 in group A was larger than in group B at T1;and airway resistance reduction in group A was larger than in group B at T1,T2 and T3（P0.05）.Conclusion In early stage,the treatment of connecting small tide volume mechanical ventilation and Respimat,which is helpful for ARDS patients in reducing lung damage,accelerating pulmonary edema dissipates,and improving the outcome,has more advantages than mechanical ventilation.