有创-无创序贯机械通气联合俯卧位治疗ARDS的临床研究

Clinical study of invasive-noninvasive sequential mechanical ventilation combined with prone position in the treatment of ARDS

目的探讨有创-无创序贯机械通气联合俯卧位治疗ARDS的临床效果。方法选择2016年2月～2018年2月间我院收治的ARDS患者100例为本次的研究对象,随机将患者分成观察组和对照组,每组50例,观察组患者给予有创-无创序贯机械通气联合俯卧位治疗,对照组气管插管行有创机械通气直到脱机,比较分析两组患者的临床效果。结果两组患者在通气后均较通气前各项临床指标有所好转,通气前后相比差异有统计学意义(P <0.05),观察组患者在通气时间和预后指标方面,VAP发生率和病死率显著低于对照组,两组相比差异有统计学意义(P <0.05)。结论通过ICU对肺外疾病造成的ARDS患者最初阶段采用俯卧位完成复张的方法的基础上,最初阶段撤除辅助呼吸器管后序贯无创机械疏通有很高的安全性,能让患者在最快的速度下实现生理学方面的肺复张,降低机械复张对肺部的伤害。

Objective To explore the clinical effect of invasive-noninvasive sequential mechanical ventilation combined with prone position in the treatment of ARDS.Methods 100 ARDS patients who were admitted and treated in our hospital from February 2016 to February 2018 were selected as research objects.They were randomly divided into the observation group and the control group,with 50 cases in each group.Patients in the observation group were treated with invasive-noninvasive sequential mechanical ventilation combined with prone position while the control group was given invasive mechanical ventilation until weaning for endotracheal intubation.Clinical curative effects of patients in two groups were compared and analyzed.Results The clinical indicators after ventilation of patients in two groups was improved compared with those before ventilation.Difference in clinical indicators before and after ventilation were statistically significant(P<0.05).In terms of ventilation time and prognostic indicators,VAP incidence and mortality of patients in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Based on the reexpansion method of patients with ARDS caused by extrapulmonary diseases in the initial stage by ICU,sequential non-invasive mechanical ventilation after the removal of auxiliary respirator tube in the initial stage has high safety,which can enable patients to achieve physiological lung recruitment at the fastest speed and reduce the damage of mechanical reexpansion to the lungs.