持续正压通气呼吸机联合氨溴索对急性呼吸窘迫综合征患者肺循环功能的影响

Influence of continuous positive airway pressure ventilator combined with ambroxol on pulmonary circulatory function of patients with acute respiratory distress syndrome

目的探讨持续正压通气(CPAP)呼吸机联合氨溴索对急性呼吸窘迫综合征(ARDS)患者肺循环功能的影响。方法 84例ARDS机械通气患者随机分为观察组及对照组,每组42例。对照组常规机械通气,观察组给予CPAP呼吸机联合氨溴索治疗。比较2组患者临床体征、血气指标及肺循环功能的变化。结果观察组氧疗时间、住院时间短于对照组,治愈率高于对照组,并发症发生率低于对照组,差异均有统计学意义(P<0.05)。观察组治疗后动脉二氧化碳分压[p(CO2)]、动脉血氧分压[p(O2)]、血氧饱和度(Sa O2)及p H显著高于对照组(P<0.05)。观察组治疗后肺循环阻力(PVR)、血管外肺水(EVLW)、平均肺动脉压(MPAP)水平显著低于对照组,而右室每搏功指数(RVSWI)高于对照组(P<0.05)。结论 CPAP联合氨溴索能有效改善ARDS患者肺循环功能,提高患者血氧饱和度,降低患者并发症的发生。

Objective To explore the influence of continuous positive airway pressure（ CPAP） ventilator combined ambroxol on pulmonary circulatory function of patients with acute respiratory distress syndrome. Methods A total of 84 ARDS patients with ventilation were randomly divided into observation group and control group,42 cases in each group. The control group was treated with conventional mechanical ventilation,while the observation group was treated with CPAP ventilator combined ambroxol. Changes of clinical signs,blood gas and pulmonary circulatory function were compared between two groups. Results The time of oxygen therapy and hospital stay in the observation group were shorter than those in the control group,the cure rate was higher than the control group,the incidence rate of complications was lower than the control group,and there were significant differences between two groups（ P〈0. 05）. After treatment,the levels of p（ CO2）,p（ O2）,Sa O2 and p H in the observation group were significantly higher than those in the control group（ P〈0.05）. After treatment,the levels of pulmonary vascular resistance（ PVR）,extra- vascular lung water（ EVLW）,mean pulmonary arterial pressure（ MPAP） in the observation group were significantly lower than those in the control group,while the level of right ventricular work index every blog（ RVSWI）was higher than the control group（ P〈0. 05）. Conclusion CPAP combined with ambroxol can effectively improve pulmonary function in patients with ARDS,improve oxygen saturation and reduce incidence of complications.