液体负平衡对腹部外伤并ARDS肺功能保护的临床研究

Clinical research of liquid negative balance on lung function of patients with abdomen injury and acute respiratory distress syndrome

目的探讨液体负平衡对腹部外伤并急性呼吸窘迫综合症(ARDS)肺保护作用。方法 103例腹部外伤合并ARDS患者分液体管理组和对照组,脉搏指示连续心输出量监测(PiCCO)指导液体管理,测定肺灌洗液IL-6浓度,记录呼吸机参数、动脉血气分析了解肺功能。结果液体管理组EVLWI、肺组织IL-6明显下降(P<0.05),动脉血气氧分压(P<0.05)提高,肺泡-动脉氧分压差下降(P<0.05),机械通气时间缩短,呼吸机支持力度下降(P<0.05),肺功能改善。结论液体负平衡可保护肺功能,与其降低炎症反应、改善氧和等有关。

Objective To discuss the safety action of liquid negative balance on lung function of patients with abdomen injury and acute respiratory distress syndrome. Methods 103 patients with abdominal trauma and ARDS patients were randomly divided into the liq- uid management group and the control group. Pulse indicating continuous cardiac output （PiCCO） was used to monitor and guide liquid management. The concentration of IL-6 in lung lavage fluid was detected. Besides, the breathing machine parameters and arterial blood gas analysis were recorded. Results The levels of EVLWI and IL-6 decreased more obviously in the liquid management group than in the control group （ P 〈 0. 05 ）. The oxygen partial pressure of arterial blood gas increased more obviously in the liquid management group than in the control group （ P 〈 0. 05 ）. The improvement of lung function was more pronounced in the liquid management group than in the con- trol group （ P 〈 0.05 ）. Conclusion Liquid negative balance can protect pulmonary function of patients with abdomen injury and ARDS, which is connected with inflammation reduction and oxygen improvement.