摘要
目的观察阶梯式呼吸管理策略在改善感染性休克伴急性肺损伤(ALI)患者中的价值。方法纳入我院2019年1月—2020年12月收治的感染性休克伴ALI患者共146例为研究对象,数字表法随机分为观察组(73例)与对照组(73例)。对照组常规护理方案,观察组阶梯式呼吸管理,对比干预前后患者心肺功能的差异。结果观察组平均动脉压、PaCO_(2)水平低于对照组,心脏指数、中心静脉压、血管外肺水指数、PaO_(2)与氧合指数高于对照组(P<0.05);观察组复苏成功率与临床总有效率高于对照组,复苏时间与呼吸平稳时间低于对照组(P<0.05);观察组气管切开率、有创呼吸机使用率及呼吸机相关性肺炎与气道并发症发生率均低于对照组(P<0.05)。结论感染性休克并急性肺损伤患者建立阶梯化呼吸管理策略能够显著改善患者的心肺功能,提高临床复苏效果,降低相关并发症风险。
Objective To observe the value of stepwise respiratory management strategy in improving patients with septic shock and acute lung injury(ALI).Methods A total of 146 patients with septic shock and ALI treated in our hospital from January 2019 to December 2020 were included as the research objects.They were randomly divided into observation group(73 cases)and control group(73 cases)by digital table method.The control group received routine nursing plan,and the observation group received stepwise respiratory management.The differences of cardiopulmonary function before and after the intervention were compared.Results The levels of mean arterial pressure,PaCO_(2)in the observation group were significantly lower than those in the control group,cardiac index,central venous pressure,extravascular lung water index,PaO_(2)and oxygenation index in the observation group were significantly higher than those in the control group(P<0.05).The success rate of resuscitation and total clinical effective rate in the observation group were significantly higher than those in the control group,and the resuscitation time and respiratory stability time in the observation group were significantly shorter than those in the control group(P<0.05).The tracheotomy rate,the rate of using invasive ventilator and the incidence of ventilator associated pneumonia and airway complications in the observation group were lower than those in the control group(P<0.05).Conclusions The establishment of stepwise respiratory management strategy in patients with septic shock and ALI can significantly improve their cardiopulmonary function,improve the effect of clinical resuscitation and reduce the risk of related complications.
作者
罗少颜
冼燕珊
马洁葵
罗瑞平
冼敏玲
LUO Shaoyan;XIAN Yanshan;MA Jiekui;LUO Ruiping;XIAN Minling(Department of Critical Medicine,Foshan First People’s Hospital(Foshan Hospital Affiliated to Sun Yat-sen University),Foshan 528000,China)
出处
《广州医药》
2023年第4期87-90,95,共5页
Guangzhou Medical Journal
关键词
感染性休克
急性肺损伤
阶梯式呼吸管理
心肺功能
septic shock
acute lung injury
stepwise respiratory management
cardiopulmonary function