肺保护性通气治疗严重胸部创伤并发急性呼吸窘迫综合征的临床效果及对通气功能的影响(1)
[摘要]目的 探討肺保护性通气治疗严重胸部创伤并发急性呼吸窘迫综合征(ARDS)患者的临床效果。方法 选取2016年4月～2019年4月我院ICU科室收治的66例严重胸部创伤并发ARDS患者作为研究对象，按照随机数字表法将其分为对照组(33例)与观察组(33例)。给予对照组患者常规治疗，给予观察组患者肺保护性通气治疗。比较两组患者的临床疗效、通气前后血气分析指标、辅助通气时间及死亡率。结果 观察组患者的临床总有效率高于对照组，差异有统计学意义(P<0.05)。两组患者通气前的氧分压(PaO2)、二氧化碳分压(PaCO2)、氧合指数(PaO2/FiO2)数值比较，差异无统计学意义(P>0.05);两组患者通气8、24 h后的PaO2、PaO2/FiO2高于通气前，PaCO2低于通气前，差异有统计学意义(P<0.05);观察组患者通气8、24 h后的PaO2、PaO2/FiO2高于对照组，PaCO2低于对照组，差异有统计学意义(P<0.05)。观察组患者的辅助通气时间短于对照组，差异有统计学意义(P<0.05);观察组患者的死亡率低于对照组，差异有统计学意义(P<0.05)。结论 肺保护性通气治疗严重胸部创伤并发ARDS疾病患者的效果显著，通气后能够改善血气分析指标，减少辅助通气时间和死亡率，具有重要的临床意义。
[关键词]肺保护性通气疗法;胸部创伤;急性呼吸窘迫综合征;临床效果
[中图分类号] R649.2 [文献标识码] A [文章编号] 1674-4721(2020)2(b)-0043-04
[Abstract] Objective To investigate the clinical effect of pulmonary protective ventilation in patients with severe chest trauma complicated by acute respiratory distress syndrome (ARDS). Methods In this study， 66 patients with severe chest trauma complicated with ARDS admitted to ICU from April 2016 to April 2019 were selected as subjects and divided into control group (33 cases) and observation group (33 cases) according to the random number table method. The control group received routine ventilation and conventional treatment， the observation group was given lung protective ventilation treatment. The clinical efficacy， blood gas analysis indicators before and after ventilation， assisted ventilation time and mortality of the two groups were compared. Results The total clinical efficiency of the patients in the observation group was higher than that of the control group， and the difference was statistically significant (P<0.05). The values of oxygen partial pressure (PaO2)， carbon dioxide partial pressure (PaCO2)， and oxygen index (PaO2/FiO2) were compared between the two groups of patients with no statistical significance (P>0.05). After 8 and 24 h of ventilation， PaO2 and PaO2/FiO2 of two groups were higher than those before ventilation， and PaCO2 was lower than that before ventilation， the differences were statistically significant (P<0.05). The PaO2 and PaO2/FiO2 after 8 and 24 h of ventilation in the observation group were higher than those in the control group， and PaCO2 was lower than that in the control group， and the differences were statistically significant (P<0.05). The auxiliary ventilation time in the observation group was shorter than that of the control group， and the difference was statistically significant (P<0.05). The mortality of patients in the observation group was lower than that of the control group， and the difference was statistically significant (P<0.05). Conclusion The effect of lung protective ventilation treating patients with severe chest trauma complicated with ARDS disease is remarkable. It can improve the blood gas analysis index and reduce the auxiliary ventilation time and mortality after ventilation. It has important clinical significance., http://www.100md.com(梁磊 姜威)
[关键词]肺保护性通气疗法;胸部创伤;急性呼吸窘迫综合征;临床效果
[中图分类号] R649.2 [文献标识码] A [文章编号] 1674-4721(2020)2(b)-0043-04
[Abstract] Objective To investigate the clinical effect of pulmonary protective ventilation in patients with severe chest trauma complicated by acute respiratory distress syndrome (ARDS). Methods In this study， 66 patients with severe chest trauma complicated with ARDS admitted to ICU from April 2016 to April 2019 were selected as subjects and divided into control group (33 cases) and observation group (33 cases) according to the random number table method. The control group received routine ventilation and conventional treatment， the observation group was given lung protective ventilation treatment. The clinical efficacy， blood gas analysis indicators before and after ventilation， assisted ventilation time and mortality of the two groups were compared. Results The total clinical efficiency of the patients in the observation group was higher than that of the control group， and the difference was statistically significant (P<0.05). The values of oxygen partial pressure (PaO2)， carbon dioxide partial pressure (PaCO2)， and oxygen index (PaO2/FiO2) were compared between the two groups of patients with no statistical significance (P>0.05). After 8 and 24 h of ventilation， PaO2 and PaO2/FiO2 of two groups were higher than those before ventilation， and PaCO2 was lower than that before ventilation， the differences were statistically significant (P<0.05). The PaO2 and PaO2/FiO2 after 8 and 24 h of ventilation in the observation group were higher than those in the control group， and PaCO2 was lower than that in the control group， and the differences were statistically significant (P<0.05). The auxiliary ventilation time in the observation group was shorter than that of the control group， and the difference was statistically significant (P<0.05). The mortality of patients in the observation group was lower than that of the control group， and the difference was statistically significant (P<0.05). Conclusion The effect of lung protective ventilation treating patients with severe chest trauma complicated with ARDS disease is remarkable. It can improve the blood gas analysis index and reduce the auxiliary ventilation time and mortality after ventilation. It has important clinical significance., http://www.100md.com(梁磊 姜威)
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