完全机械通气与支气管解痉药联合应用治疗ARDS的应用研究

Reaearch of ARDS Teated by Complete Mechanical Ventulation Combined with Broncho Dilator

于 1996年后采用一种新的通气模式 (以下称新模式 ) ,经临床实践 ,效果满意。即应用肌松剂 ,使呼吸肌松弛 ,解除了自主呼吸与机械通气的对抗 ,改善肺通气 ;合理应用PEEP ,提高功能残余气量 ,改善肺顺应性 ,预防改善肺泡群萎陷 ,减少肺间质渗出 ,改善了气血交换 ;应用支气管解痉剂 ,解除支气管平滑肌痉挛 ,降低气道阻力 ,改善了肺通气。从以上 3个方面减少了肺内死腔 ,改善肺通气 /血流比 ,迅速提高PaO2 ,明显缩短带机时间 ,疗效满意 。

From 1996,a new mechanical ventilation mode has been used in patients with ARDS.The result was satisfactory.In our practice,muscle-paralising drugswere used to had the respiratory muscles paralised and this will elimilate the phynomenon of patient-anti-ventilator,so ventilation in lung was amelioated.PEEP was also used to lift the functional residual volume of gas in lung and to improve the compliance of lung.This will prevent the lung from collapsing\,lessen the effusion in mesenchyma of lung and improve gas exchange Bronchodilator was used to lessen spasm of smooth muscle in bronchi and to lower air-way resistance.Then ventilation will also be amelioated.The above procedures can lessen the dead cavity in lung\,improve ventilation/blood ratio\,rapidly lift the Po2.The time requiring mechanical assistance in patients with ARDS was shortened considerably.The mortality of patients was lowered considerably.