肌松剂在创伤后急性呼吸窘迫综合征机械通气患者中的应用效果

Application Effect of Muscle Relaxant in Patients with Post-traumatic Acute Respiratory Distress Syndrome Undergoing Mechanical Ventilation

目的探讨肌松剂在创伤后急性呼吸窘迫综合征机械通气患者中的应用效果。方法选取2021年6月-2022年6月贵州省黔南布依族苗族自治州中医医院呼吸与危重症及重症医学科收治的创伤后ARDS患者100例,按照随机数字表法分为对照组和观察组,每组50例。对照组予以镇静、镇痛治疗,观察组在以上镇静、镇痛基础上联合应用肌松药物维库溴铵静脉泵入,比较两组氧合变化(pH、PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2))、质量效果(28 d无机械通气日、ICU住院日、住院费用、VAP患病率、住院病死率)。结果观察组的pH、PaO_(2)、PaCO_(2)、PaO_(2)/FiO_(2)、28 d无机械通气日、ICU住院日、住院费用、VAP患病率、住院病死率优于对照组,差异有统计学意义(P<0.05)。结论肌松剂可改善创伤后急性呼吸窘迫综合征机械通气患者氧合指数,促进患者自主呼吸功能恢复,缩短住院时间,降低VAP患病率、住院病死率。

Objective To investigate the application effect of muscle relaxant in patients with post-traumatic acute respiratory distress syndrome undergoing mechanical ventilation.Methods From June 2021 to June 2022,100 patients with post-traumatic ARDS admitted to the Department of Respiratory and Critical Care and Intensive Medicine of Qiannan Buyi and Miao Autonomous Prefecture Hospital of Traditional Chinese Medicine in Guizhou Province were selected and divided into control group and observation group according to the random number table method,with 50 patients in each group.The control group was treated with sedation and analgesia,and the observation group was treated with muscle relaxant vecuronium bromide intravenous infusion on the basis of the above sedation and analgesia.The oxygenation changes(pH,PaO_(2),PaCO_(2),PaO_(2)/FiO_(2))and quality effects(28 d no mechanical ventilation days,ICU hospitalization days,hospitalization costs,VAP prevalence,hospitalization mortality)were compared between the two groups.Results The pH,PaO_(2),PaCO_(2),PaO_(2)/FiO_(2),28 d no mechanical ventilation days,ICU hospitalization days,hospitalization expenses,VAP prevalence and hospitalization mortality of the observation group were better than those of the control group,and the differences were statistically significant(P<0.05).Conclusion Muscle relaxant can improve the oxygenation index of patients with post-traumatic acute respiratory distress syndrome undergoing mechanical ventilation,promote the recovery of spontaneous respiratory function,shorten the length of hospital stay,and reduce the prevalence of VAP and hospital mortality.