不同机械通气方式治疗急性呼吸窘迫综合症疗效对比

宋静+王征+邓琳瑕

[摘要] 目的 探讨肺外性急性呼吸窘迫综合症（ARDSexp）治疗中，应用呼气末正压递增（PI）和持续气道正压（CPAP）两种不同机械通气方式的临床治疗效果。 方法 将2013年1月—2013年12月期间该科收治的52例ARDSexp患者随机分为接受PI方式机械通气治疗（PI组）及受CPAP方式机械通气治疗（CPAP组）两组，每组26例。分析两组临床治疗效果。结果 两组在接受机械通气前，血气分析（PaO2、PaCO2、PaO2/FiO2）、心率（HR）、收缩压（SBP）及舒张压（DBP）比较未见统计学差异（P>0.05），经治疗后15 min后两组PaO2及PaO2/FiO2显著提高（P<0.05），并可维持至3 h（P<0.05）。两组间比较未见统计学差异（P>0.05）。两组PaCO2治疗前后比较未见统计学差异。但两组治疗15 min及治疗3 h与治疗前HR、SBP及DBP比较未见统计学差异（P>0.05），且两组治疗15 min及治疗3 h比较未见统计学差异（P>0.05）。结论 ARDSexp患者应用PI及CPAP两种机械通气方式均有着较好的临床治疗效果。

[关键词] 肺外性急性呼吸窘迫综合症；呼气末正压递增；持续气道正压

[中图分类号] R563.8 [文献标识码] A [文章编号] 1674-0742（2015）02（b）-0008-03

Comparison of the Effect Between Different Mechanical Ventilation Modes in the Treatment of Acute Respiratory Distress Syndrome

SONG Jing1 WANG Zheng2 DENG Linxia1

1.Department of Geriatrics， Dalian Friendship Hospital， Dalian， Liaoning Province， 116001 China

2.Department of Emergency， Dalian Friendship Hospital， Dalian， Liaoning Province， 116001 China

[Abstract] Objective To investigate the clinical effect of positive end-expiratory pressure increasing （PI） and continuous positive airway pressure（CPAP） these two different modes of mechanical ventilation in the treatment of extrapulmonary acute respiratory distress syndrome（ARDSexp）. Methods Fifty-two cases with ARDSexp admitted to the hospital from January 2013 to December 2013 were randomly divided into PI group treated by PI mode mechanical ventilation， and the CPAP group treated by CPAP with 26 cases in each. And the clinical effects of the two groups were analyzed. Results Before receiving mechanical ventilation， there were no statistically significant differences between blood gas analysis（PaO2， PaCO2， PaO2/FiO2）， heart rate（HR）， systolic blood pressure（SBP） and diastolic blood pressure （DBP） between the two groups（P>0.05）. 15 minutes after treatment， the levels of PaO2， PaO2/FiO2 of both groups increased significantly（P<0.05）， and which could keep for 3 hours （P<0.05）； and the differences between the two groups were not statistically significant（P>0.05）. The difference in the level of PaCO2 of the two groups before and after treatment was not statistically significant. No statistically significant differences were found in HR， SBP and DBP before treatment and 15 minutes and 3 hours after treatment in both groups（P>0.05）， and the differences in those 15 minutes and 3 hours after treatment between the two groups were not statistically significant（P>0.05）. Conclusion Both PI and CPAP mechanical ventilation modes have good clinical effect on patients with ARDSexp.