急性呼吸窘迫综合征患者吸痰负压与肺复张容积缺失值的关联分析

The correlation analysis between the negative pressure sputum aspiration and the loss volume of pulmonary recruitment in patients with acute respiratory distress syndrome

目的探讨急性呼吸窘迫综合征（ARDS）患者不同吸痰负压与肺复张容积缺失值的相关与回归关系。方法前瞻性自身对照分析ARDS患者28例，分别使用150、160、170、180、190及200mmHg的负压进行开放式吸痰，记录不同负压吸痰前后肺容积的变化。结果吸痰负压与缺失肺复张容积之间存在显著的正相关关系（r=0．513，P=0．000），即吸痰负压越大，其引起的肺容积缺失越多，差异有统计学意义（P〈0．001）。结论不同的吸痰负压能够引起肺复张容积明显的改变，对ARDS患者进行吸痰后的肺复张，应参考吸痰负压所引起的相应肺容积缺失值，以防止过度或者不足通气引起ARDS患者的肺损伤。

Objective To investigation the correlation and regression relationship between the different negative pressures sputum aspiration and the loss volume of pulmonary recruitment in patients with ARDS, for clinical selection the proper of recruitment strategy to provide reference. Methods In prospective and self controlled study, twenty - eight patients fulfilling criteria for acute respiratory distress syndrome were eligible. They were randomly assigned to be endotr - acheal suctioning with pressure 150,160,170,180,190 or 200 mm Hg, then standard procedure endotracheal suctioning. Record the volume lung re -expansion before and after different negative sputum aspiration. Results There were significant positive correlation between the negative pressure sputum aspiration and the loss volume of pulmonary （r = O. 513, P = 0. 000）. The higher pressure of sputum aspiration induced the more loss volume of pulmonary recruitment. Conclusion The different pressure of sputum aspiration can cause the change of lung recruited volume. On ARDS patients the lung recruitment after sputum aspiration should refer to the missing values caused by the negative pressure sputum aspiration, to prevent the excessive or inadequate ventilation induced lung injury.