小儿急性呼吸窘迫综合征肺功能变化的临床研究

Clinical Study on the Change of Pulmonary Function in Children with Acute Respiratory Distress Syndrome

目的研究急性呼吸窘迫综合征(ARDS)伴急性肺损伤(ALI)患儿的肺功能变化情况。方法选择我院2014年3月至2016年3月期间收治的ARDS伴ALI患儿48例作为观察组,另选取同期我院收治的48例ARDS无ALI的患儿作为对照组,两组患儿均采用机械通气辅助呼吸。观察两组患儿的肺功能、呼吸机参数以及预后情况。结果两组患儿的Cst、Qs/Qt、PaO_2以及PaO_2/FiO_2水平比较,差异有统计学意义(P<0.05)。观察组的呼吸机参数均大于对照组(P<0.05)。观察组患儿的MODS发生率为20.83%,明显高于对照组的6.25%,差异有统计学意义(P<0.05)。结论发生ALI的ARDS患儿呼吸机参数普遍偏高,肺功能明显下降,MODS发生率显著上升,对于ARDS患儿应密切关注是否发生肺损伤,尽早进行干预,以降低病死率。

Objective To study the change of pulmonary function in children with acute respiratory distress syndrome（ARDS）associated with acute lung injury（ALI）. Methods 48 cases of children with ARDS associated with ALI in our hospital from March 2014 to March 2016 were selected as observation group,and 48 cases of ARDS children without ALI at the same period in our hospital were selected as control group. Both groups were treated with mechanical ventilation assisted respiration. The pulmonary function,ventilator parameters and prognosis were observed between two groups. Results Compared with the control group,the levels of PaO2/FiO2,Qs/Qt,PaO2 and Cst in the observation group were statistically different（P〈0.05）. The ventilator parameters in the observation group were higher than those in the control group（P〈0.05）. The incidence rate of MODS in the observation group was 20.83%,significantly higher than 6.25% in the control group,with statistically significant difference（P〈0.05）. Conclusions ARDS children with ALI have higher ventilator parameters,with obviously declined pulmonary function,and significantly increased occurrence rate of MODS. For ARDS children,close attention should be paid to the occurrence of lung injury,and intervention measures should be taken as early as possible to reduce the mortality rate.