特定通气条件下氧合指数对急性呼吸窘迫综合征预后的评估价值

发布时间：2018-06-04 23:32

  本文选题：急性呼吸窘迫综合征 + 氧合指数　； 参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:探讨特定通气条件下氧合指数(PaO2/Fi O2)及其改善值对急性呼吸窘迫综合征(ARDS)患者预后的评估价值。方法:将新疆医科大学第一附属医院重症医学科2015年3月至2016年5月收治的中重度ARDS患者27例进行前瞻性研究。收集临床资(包括性别、年龄、病因、诱因、合并基础疾病、血气分析、血常规、电解质、肝肾功、凝血、血压、心率等生命体征、机械通气方式、通气时间、ICU滞留时间、总住院时间、急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、序贯器官衰竭估计评分(SOFA)评分、是否发生MODS累及器官数目、预后等)。诊断ARDS并机械通气24 h后,在固定的通气方式下通气30 min,检测动脉血气。观察患者28 d生存率,并分为生存组和死亡组。结果:入选27例中重度ARDS患者,其中、重度患者分别为22例、5例。特定通气条件下通气后PaO2/FiO2高于入组时[172.83±60.65比140.54±41.87(mm Hg,1mmHg=0.133kPa),P=0.01],PaO2/FiO2≤300且200mmHg者、PaO2/FiO2≤200且100mmHg者分别为8例、19例。28d死亡12人,病死率44.4%。与死亡组相比,生存组APACHEⅡ评分较低(22.75±2.6比18.33±3.4,P=0.010),SOFA评分较低(9.53±1.9比12.0±2.5,P=0.034),特定通气条件下通气后PaO2/FiO2较高[193.79±66.4比146.6±41.5(mm Hg),P=0.01],特定条件通气后PaO2/FiO2改善值较高[62.36±50.39比2.12±70.60(mmHg),P=0.022]。结论:特定通气条件下的氧合指数及其改善值能反应ARDS患者病情和评估预后。
[Abstract]:Objective: to evaluate the value of PaO2 / FiO2) and its improvement in the prognosis of ARDS patients with acute respiratory distress syndrome (ARDS) under specific ventilation conditions. Methods: from March 2015 to May 2016, 27 patients with moderate and severe ARDS in the Department of intensive Medicine, the first affiliated Hospital of Xinjiang Medical University, were studied prospectively. To collect clinical information (including sex, age, etiology, inducement, complicated basic diseases, blood gas analysis, blood routine examination, electrolyte, liver and kidney function, coagulation, blood pressure, heart rate and other vital signs, mechanical ventilation mode, ventilation time, etc. Total hospitalization time, acute physiology and chronic health status scoring system 鈪，

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