逐步肺复张在主动脉夹层患者术后低氧中的应用

Application effects of progressive lung recruitment technique in patients with postoperative hypoxic aortic dissection

目的探究并分析逐步肺复张技术在术后低氧的主动脉夹层患者中的应用效果。方法选取2020年2月至2021年2月103例术后低氧的主动脉夹层患者,按照随机数字表法分为对照组(51例)和观察组(52例)。对照组给予常规机械通气治疗,观察组给予逐步肺复张治疗。观察并记录2组患者一般资料(包括性别、Stanford分型、年龄、体重、合并基础疾病、发病-入院时间等),2组患者治疗前后生命体征,治疗前后血气分析及治疗结局。结果治疗前2组患者HR、RR、SBP、SpO_(2)等生命体征比较无差异(P>0.05),治疗后2组患者各项生命体征均得到显著改善(P<0.05),观察组患者治疗后HR、RR、SBP、SpO_(2)等生命体征均显著优于对照组(P<0.05);治疗前2组患者pH值、动脉血氧分压、动脉二氧化碳分压、碱剩余等血气分析结果比较无差异(P>0.05),治疗后2组患者血气分析结果均得到显著改善(P<0.05),观察组均较对照组显著改善(P<0.05);观察组患者平均气道护理干预次数、呼吸支持时间、ICU住院时间、总住院时间均显著低于对照组(P<0.05)。结论逐步肺复张技术能有效改善术后低氧的主动脉夹层患者生命体征及血气分析结果,减少患者呼吸支持及住院时间,值得临床推广。

Objective To investigate the application effects of progressive lung recruitment technique in patients with postoperative hypoxic aortic dissection.Methods A total of 103 patients with postoperative hypoxic aortic dissection who were treated in our hospital were enrolled in the study,who were randomly divided into control group(n=51)and observation group(n=52).The patients in control group were treated by conventional mechanical ventilation,however,those in observation group were treated by gradual lung recruitment.The general data including patient’s gender and age,Stanford typing,body weight,combined basic diseases,onset admission time,and the vital signs,blood gas analysis and treatment outcome were observed and compared between the two groups.Results Before treatment there were no significant differences in HR,RR,SBP,SpO_(2) and other vital signs between the two groups(P>0.05).After treatment,the vital signs in both groyps were significantly improved(P<0.05),moreover,which in observation group were superior to those in control group(P<0.05).Before treatment there were no significant differences in pH value,arterial oxygen partial pressure,arterial carbon dioxide partial pressure and alkali residue between the two groups(P>0.05).After treatment,the above indexes in both groups were significantly improved(P<0.05),moreover,which in observation group were superior to those in control group(P<0.05).In addition the average times of airway nursing intervention,respiratory support time,ICU hospital stay and total hospital stay in observation group were significantly lower than those in control group(P<0.05).Conclusion The stepwise lung recruitment technique can effectively improve the vital signs and blood gas analysis results in patients with postoperative hypoxic aortic dissection,and can decrease the respiratory support time and hospital stay,therefore,it is worthy of clinical promotion.