呼吸机在严重烧伤延迟复苏患者休克期的应用

Application of the respirator to severely burned patients with delayed fluid resuscitation during shock stage

目的 探讨呼吸机在严重延迟复苏患者休克期的合理应用。方法 将 4 6例延迟复苏烧伤患者按是否应用呼吸机辅助通气治疗分成 2组 ,即呼吸机治疗组 (V组 )和非呼吸机治疗组 (NV组 ) ,比较分析 2组动脉血气和血清乳酸浓度(BLA)。结果 V组动脉血PaO2 、PaCO2 、BD(basedeficit)高于通气前 ,机械通气前后PaO2 /吸入氧的浓度 (FiO2 )比值即氧合指数(MRI)、呼吸频率 (RR)、脉搏氧饱和度 (SpO2 )较通气前均有明显改善。V组除入院即刻外各时相点BLA均低于NV组 (P <0 0 1～ 0 0 5 )。结论 早期应用呼吸机辅助通气治疗可改善氧动力学指标 ,有助于休克期的平稳过渡。

Objective To investigate clinical effect of application ventilation on oxygenation in severely burned patients with delayed fluid resuscitation during shock stage. Methods From January 1995 to December 2001, 46 cases with delayed fluid resuscitation were admitted to our burn department and divided into two different groups: one was treated with ventilatory support (respirator group, group V), and the other without ventilatory support (non-respirator group, group NV). Results ①Levels of blood lactic acid (BLA) in group V was very significantly lower than that of group NV. ②PaO 2, base deficit were increased in the group V (P<0.01～0.05).③Lower respiratory rate (RR) and modificatine respiratory index (MRI), higher saturation of oxygen(SpO 2) were measured after the beginning ventilatory support (P<0.01～0.05). Conclusion Ventilatory support can improve the oxygenation of tissue and play an important role in fluid resuscitation during shock stage.