高频振荡通气对烟雾吸入性肺损伤致急性呼吸窘迫综合征患者临床疗效及预后的影响

发布时间：2018-01-07 15:05

本文关键词：高频振荡通气对烟雾吸入性肺损伤致急性呼吸窘迫综合征患者临床疗效及预后的影响　出处：《中国呼吸与危重监护杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的通过回顾性分析探究高频振荡通气与常规机械通气对烟雾吸入性肺损伤致急性呼吸窘迫综合征(ARDS)患者的临床疗效,为选择正确的通气模式提供参考。方法收集我院危重病监护中心2004年10月至2015年6月期间烧伤合并烟雾吸入性肺损伤致ARDS患者43例,其中24例接受高频振荡通气治疗(HFOV组),19例接受常规通气治疗(CV组),对比分析两组患者于入院后规定时间点(第6 h、24 h、48 h、96 h、7 d)的血气变化、并发症和预后情况。结果通气治疗前两组患者动脉血氧分压(PaO_2)、动脉二氧化碳分压(PaCO_2)、动脉血氧分压/吸氧浓度比值(PaO_2/FiO_2)差异无统计学意义(P0.05),通气治疗后除第48 h、96h PaCO_2未见明显差异外(P0.05),其余规定时点HFOV组各血气指标较CV组改善更明显(P0.05)。HFOV组患者住院与通气时间较CV组明显缩短(P0.05)。两组患者死亡率与严重并发症发生率差异均无统计学意义(P0.05),30天累计生存率提示两组患者生存曲线无显著差异(P0.05)。结论高频振荡通气与常规通气模式均能改善烟雾吸入性肺损伤致ARDS患者的临床状况,当前研究并不能说明两种通气模式下患者预后具有差异。
[Abstract]:Objective To retrospectively explore high frequency oscillatory ventilation and conventional mechanical ventilation on smoke inhalation lung injury caused by acute respiratory distress syndrome (ARDS) patients with clinical curative effect, provide a reference for the choice of ventilation right. Methods in our hospital from October 2004 to June 2015 the center of critically ill patients during combined burn and smoke inhalation lung injury in patients with ARDS 43 cases accepted high frequency oscillatory ventilation in the treatment of 24 cases (HFOV group), 19 patients received conventional ventilation treatment (CV group), compared two groups of patients admitted to hospital after the specified time points (sixth h, 24 h, 48 h, 96 h, 7 d) of the blood gas changes, complications and prognosis. Ventilation in the treatment of two groups of patients before arterial oxygen partial pressure (PaO_2), arterial partial pressure of carbon dioxide (PaCO_2), PaO2 / oxygen concentration ratio (PaO_2/FiO_2) showed no significant difference (P0.05), forty-eighth h after ventilation in addition to 96h, no PaCO_2 Significant difference (P0.05), the remaining provisions of group HFOV at each blood gas index than the CV group improved significantly (P0.05) and ventilation time was significantly shorter than that of group CV in.HFOV group (P0.05). The two groups of patients with the mortality rate of serious complications showed no significant difference (P0.05), 30 day cumulative survival tips two groups had no significant difference in survival curve (P0.05). Conclusion high frequency oscillatory ventilation and conventional ventilation mode can improve the clinical status of smoke inhalation injury induced by ARDS in patients with lung, current research does not explain the two ventilation mode with the prognosis of patients with difference.

【作者单位】：辽宁省葫芦岛市中心医院;辽宁医学院第一附属医院;
【分类号】：R563.8
【正文快照】： 烟雾吸入性肺损伤是指吸入有毒烟雾或化学物质对呼吸道及肺实质的损害,多发生于大面积尤其是伴有头面部烧伤的患者,吸入时烟雾中的高热量是产生损害的直接原因且主要损伤上呼吸道,同时烟雾中含有的有毒气体、颗粒、化合物的作用也不可忽视[1]。在上述因素的共同作用下,Ⅱ型肺

【共引文献】