58例严重胸外伤致急性呼吸窘迫综合征的治疗体会

Treatment Experience of Acute Respiratory Distress Syndrome Caused by 58 Cases Severe Thoracic Injury

目的探讨早期有创机械通气联合血必净注射液在严重胸外伤致急性呼吸窘迫综合征(ARDS)中的临床效果。方法将符合病例入选标准的58例患者随机分为观察组、对照组,对照组30例,采用常规治疗方法,观察组28例,伤后24 h内采用早期有创机械通气联合血必净注射液,比较两组治疗后生命体征、氧合情况、血乳酸、Hs-CRP等指标的变化。结果治疗24 h、72 h后,观察组的生命体征指标改善明显,pH、PaO2、PaCO2、PaO2/FiO2、乳酸指标明显优于对照组,Hs-CRP较对照组明显下降,比较差异均有统计学意义(P<0.05)。结论严重胸外伤致ARDS患者,早期采用有创机械通气联合血必净注射液治疗能更好改善患者动脉血氧合、稳定血流动力学,具有较好的临床疗效。

Objective To investigate the clinical efifcacy of early invasive mechanical ventilation and Xuebijing injection in severe respiratory distress syndrome caused by thoracic trauma. Methods 58 patients selected complied with the standard were randomly divided into two groups. Control group 30 cases, adopt the conventional treatment methods. Observation group 28 cases, within 24 h after injury as early invasive mechanical ventilation and Xuebijing injection, compared two groups of vital signs, oxygenation, blood lactic acid, high-sensitivity C-reactive proteinand and other indicators before and after treatment. Results The 24 h, 72 h after treatment, vital signs index of the observation group improved signiifcantly, The pH, PaO2, PaCO2, PaO2/FiO2, lactic acid was better than the control group, The Hs - CRP was signiifcantly decreased there was a signiifcant difference P〈0.05. Conclusion Early invasive mechanical ventilation combined with Xuebijing injection in respiratory distress syndrome caused by severe chest trauma has a better clinical efifcacy and improve patients with arterial blood oxygenation, stable hemodynamics.