肺部超声在急性呼吸窘迫综合征患者肺复张治疗中的应用

Application of Lung Ultrasound in the Treatment of Lung Recruitment in Patients with Acute Respiratory Distress Syndrome

目的探析肺部超声在急性呼吸窘迫综合征患者肺复张治疗中的应用效果。方法便利选取2015年5月—2020年2月于该院接受肺复张治疗的92例急性呼吸窘迫综合征患者,采用随机数表法将其分为肺部超声组(n=48)和肺部氧合组(n=44),分别比较两组患者肺复张前后心率(HR)、平均动脉压(MAP)、氧合指数(PaO_(2)/FiO_(2))、中心静脉压(CVP)、肺部超声评分(LUS)及两组患者肺复张后的ΔCVP、ΔMAP、Δ氧合指数、ΔLUS绝对值水平,比较两组患者住院时间及恶性事件发生情况。结果两组患者肺复张后的HR、CVP、MAP、PaO_(2)/FiO_(2)、LUS等血流动力学指标相比较,差异无统计学意义(P>0.05)。肺部超声组肺复张后的ΔCVP、ΔMAP、Δ氧合指数绝对值水平优于肺部氧合组,差异无统计学意义(P>0.05);肺部超声组肺复张后的住院时间、ΔLUS绝对值水平分别为(16.67±3.74)d、(-2.19±1.91)分,显著优于肺部氧合组,差异有统计学意义(t=6.428,2.443,P<0.05)。肺部超声组恶性事件发生率为4.17%,显著低于肺部氧合组,差异有统计学意义(χ^(2)=6.973,P<0.05)。结论肺部超声用于急性呼吸窘迫综合征患者肺复张治疗中安全高效且能缩短住院时间,值得推广应用。

Objective To explore the effect of lung ultrasound in the treatment of lung recruitment in patients with acute respiratory distress syndrome.Methods A total of 92 patients with acute respiratory distress syndrome who received lung recruitment therapy in the hospital from May 2015 to February 2020 were conveniently selected and divided into lung ultrasound group(n=48)and the lung oxygenation group(n=44)by random number table method,the heart rate(HR),mean arterial pressure(MAP),oxygenation index(PaO_(2)/FiO_(2)),central venous pressure(CVP),and lung ultrasound score(LUS)andΔCVP,ΔMAP,Δoxygenation index,ΔLUS absolute value levels after lung recruitment in the two groups were compared between the two groups before and after lung recruitment,and compared the hospital stay and the occurrence of malignant events between the two groups.Results There was no significant difference in hemodynamic indexes such as HR,CVP,MAP,PaO_(2)/FiO_(2),LUS after lung recruitment between the two groups of patients(P>0.05).The absolute values ofΔCVP,ΔMAP,andΔoxygenation index after recruitment of lung ultrasound group were better than those of lung oxygenation group,the difference was not statistically significant(P>0.05);lung ultrasound group was hospitalized after lung recruitment,the absolute value levels of time andΔLUS were(16.67±3.74)d and(-2.19±1.91)points significantly better than those in the lung oxygenation group,and the difference was statistically significant(t=6.428,2.443,P<0.05).The incidence of malignant events in the lung ultrasound group was 4.17%,which was significantly lower than that in the lung oxygenation group,and the difference was statistically significant(χ^(2)=6.973,P<0.05).Conclusion Pulmonary ultrasound is safe and effective in the treatment of lung recruitment in patients with acute respiratory distress syndrome,and can shorten the length of hospitalization.It is worthy of popularization and application.