分肺机械通气治疗严重非对称性肺损伤的临床探讨

Points of Lung Mechanical Ventilation in the Treatment of Severe Asymmetric Lung Injury

目的分析分肺机械通气治疗严重非对称性肺损伤临床疗效。方法选取从2014年3月—2016年3月在该院治疗的20例因严重非对称性肺损伤致急性呼吸衰竭患者,在常规机械通气无效后采取分肺机械通气,观察通气前后氧合指标、血流动力学以及呼吸力学。结果分肺24 h SaO_2(92.9±2.7)%、PaO_2/FiO_2(253.2±41.5)mmHg、QS/QT(12.3±4.6)%、MAP(80.8±17.5)%等指标明显优于分肺前(t=8.599、11.098、17.585、2.412,P<0.05)。分肺24 h患侧肺PETCO_2(18.7±4.6)mmHg、患侧肺Cst(37.8±5.8)mL/cm H_2O、健侧肺VD/VT(0.35±0.12)%、患侧肺Raw(10.5±2.2)cm H_2O/(L·S)优于分肺前(t=6.499、10.119、7.967、21.909,P<0.05)。结论对严重非对称性肺损伤患者采取分肺机械通气,可改善患者病情,具有临床应用价值。

Objective To analyze points of lung mechanical ventilation treatment of severe asymmetric lung injury clinical curative effect. Methods Select from March 2014 to March 2016 in our hospital treatment of 20 cases Because of the serious asymmetry lung injury in patients with acute respiratory failure,in conventional mechanical ventilation is invalid to divide the lung after mechanical ventilation, were observed before and after aeration oxygenation index, hemodynamic and respiratory mechanics. Results Pulmonary lung 24 h SaO2（92.9±2.7）%, PaOb/FiO2（2.532±41.5） mmHg,QS/QT（12.3±4.6）%, MAP（80.8±17.5）% etc. index was significantly better than before（t=8.599、11.098、17.585、2.412,P〈0.05）. Partial lung 24 h from the contralateral lung PEtCO2（18.7±4.6） mmHg, suffering from unilateral lung CST（37.8±5.8） mL/cm H2 O, healthy contralateral lung VD/VT（0.35±0.12）%, suffering from unilateral lung Raw（10.5±2.2）cm H2O/（L·S）（t =6.499、10.119、7.967、21.909,P〈0.05）. Conclusion In patients with severe asymmetric lung injury to lung mechanical ventilation, can improve the patients, have clinical application value.