控制性肺膨胀术治疗肺外型急性呼吸窘迫综合征的疗效分析

Effect of Sustained Inflation in Extrapulmonary Acute Respiratory Distress Syndrome

目的:评价控制性肺膨胀(sustained inflation,SI)在肺外型急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)的应用效果。方法:选择2011年1月—2012年9月入住延安大学附属医院重症医学科的24例肺外源型ARDS患者,随机分为对照组10例,SI组14例。两组均进行保护性肺通气,SI组采用SI(45 cmH2O,20 s)。比较两组患者的心率(HR)、平均动脉压(MAP)、指末氧饱和度(SpO2)、氧合指数(PaO2/FiO2)、机械通气时间及住ICU时间。结果:SI组患者SI后2 h,SpO2、PaO2/FiO2较对照组明显增高,差异具有统计学意义(P<0.05);两组HR、MAP、机械通气时间、住ICU时间(P>0.05)差异无统计学意义。SI组无明显并发症出现。结论:SI能有效改善肺外型ARDS患者的氧合能力,对血液动力学影响较小,是安全有效的肺复张方法。

Objective：To study clinical effectiveness of sustained inflation （SI）on extrapulmonary acute respiratory disstress syndrome（ARDS）.Methods：Twenty-four patients with extrapulmonary ARDS were included from January 2011 to September 2012 .Patients were randomly divided into control group （n=10）and SI group （n=14）.Both groups were given lung protec-tive ventilation （LPV）,and SI （45 cmH2 O,20 s）was conducted for alveolar recruitment in SI group.Heart rate （HR）,mean arterial pressure （MAP）,transcutaneous oxygen saturation （SpO2 ）,PaO2/FiO2 ,mechanical ventilation time,ICU hospitaliza-tion time were compared between the two groups.Results：SpO2 ,PaO2/FiO2 were increased significantly at 2 h after applying SI in SI group （P 〈0.05）,while there were no significant differences in HR,MAP,mechanical ventilation time,ICU hospitali-zation time between the two groups （P 〉0.05）.No other serious complications were observed.Conclusions：SI can effectively improve oxygenation in patients with extrapulmonary ARDS.It is safe and effective to hemodynamics alveolar recruitment.