APRV和SIMV+PSV机械通气模式对于急性呼吸窘迫综合征患者治疗效果的影响

Effects of APRV and SIMV+PSV mechanical ventilation modes on the treatment effect of patients with acute respiratory distress syndrome

目的:探讨急性呼吸窘迫综合征患者采用气道压力释放通气(APRV)和同步间歇指令通气联合压力支持通气(SIMV+PSV)机械通气模式治疗的效果。方法:2014年12月-2016年12月选择本院收治的急性呼吸窘迫综合征患者50例为研究对象,随机分为两组,各25例。观察组采用APRV机械通气模式治疗;对照组采用SIMV+PSV模式治疗。比较两组治疗效果。结果:观察组治疗24 h后动态肺顺应性、血管外肺水指数、肿瘤坏死因子α、白细胞介素6等指标水平均优于对照组,差异有统计学意义(P<0.05)。观察组镇静药物使用剂量明显低于对照组,且膈肌厚度和膈肌运动幅度均明显高于对照组,差异有统计学意义(P<0.05)。结论:急性呼吸窘迫综合征采取APRV机械通气模式治疗效果优于SIMV+PSV模式。

Objective:To investigate the effect of airway pressure-releasing ventilation(APRV)and synchronous intermittent command ventilation combined with pressure-supported ventilation(SIMV+PSV)in patients with acute respiratory distress syndrome.Methods:From December 2014 to December 2016,50 patients with acute respiratory distress syndrome in our hospital were enrolled,they were randomly divided into two groups with 25 cases in each group.The observation group was treated with APRV mechanical ventilation mode.The control group was treated with SIMV+PSV mode.The therapeutic effects between the two groups was compared.Results:After 24 hours of treatment,the dynamic lung compliance,extravascular lung water index,tumor necrosis factor-α,interleukin-6 and other indicators of the observation group were better than the control group,the differences were statistically significant(P<0.05).The dosage of sedative drugs in observation group was significantly lower than that in control group,diaphragm thickness and motion amplitude were significantly higher than those of control group,the differences were statistically significant(P<0.05).Conclusion:The APRV mechanical ventilation mode is better than SIMV+PSV mode for acute respiratory distress syndrome.