摘要
目的探讨针对急性呼吸窘迫综合征(ARDS)患者实施气道压力释放通气(APRV)治疗的临床效果.方法选择2018年4月—2022年5月该院收治的60例ARDS为研究对象,按随机数字表法分为两组,各30例.对照组采用小潮气量通气结合呼气末正压通气,观察组采用APRV.对比两组血气分析、呼吸力学、血流动力学以及预后情况.结果观察组治疗后动脉血氧饱和度、动脉血氧分压、氧合指数水平分别为(95.15±3.02)%、(75.11±5.03)mmHg、(165.65±15.13)mmHg,均高于对照组的(92.94±2.93)%、(72.01±4.44)mmHg、(130.37±14.44)mmHg,组间差异有统计学意义(P<0.05).观察组治疗后平均气道压、呼吸系统顺应性水平分别为(21.26±2.36)cmH_(2)O、(37.06±5.44)mL/cmH_(2)O,均高于对照组的(17.22±2.25)cmH_(2)O、(31.17±5.02)mL/cmH_(2)O,平台压、吸气峰压水平分别为(20.15±2.39)cmH_(2)O、(22.47±3.27)cmH_(2)O,均低于对照组的(24.25±2.62)cmH_(2)O、(25.27±3.15)cmH_(2)O,组间差异有统计学意义(P<0.05).观察组治疗后平均动脉压水平为(88.60±10.43)mmHg,高于对照组的(81.86±10.25)mmHg,中心静脉压水平为(7.11±1.46)mmHg,低于对照组的(14.33±2.28)mmHg,组间差异有统计学意义(P<0.05).观察组机械通气时间为(9.12±1.78)d,短于对照组的(10.21±2.12)d,差异有统计学意义(P<0.05).结论APRV能够改善ARDS患者的血气分析与呼吸力学情况,稳定血流动力学,缩短机械通气时间.
Objective To explore the clinical effect of airway pressure relief ventilation(APRV)for patients with acute respiratory distress syndrome(ARDS).Methods 60 patients with ARDS admitted to the hospital from April 2018 to May 2022 were selected as the research objects and were randomly divided into two groups,with 30 patients in each group.The control group was treated with low tidal volume ventilation combined with positive end-expiratory pressure ventilation,the observation group was treated with APRV.The blood gas analysis,respiratory mechanics,hemodynamic and prognosis of the two groups were compared.Results The levels of blood oxygen saturation,percentage of arterial blood partial pressure of oxygen and arterial blood partial pressure of oxygen and fraction of inspiration O2 in the observation group after treatment were(95.15±3.02)%,(75.11±5.03)mmHg and(165.65±15.13)mmHg,respectively,which were higher than(92.94±2.93)%,(72.01±4.44)mmHg,(130.37±14.44)mmHg in the control group,the levels of mean airway pressure and respiratory system compliance in observation group after treatment were(21.26±2.36)cmH_(2)O and(37.06±5.44)mL/cmH_(2)O,respectively,which were higher than(17.22±2.25)cmH_(2)O and(31.17±5.02)mL/cmH_(2)O in control group,the levels of plateau pressure and peak inflation pressure were(20.15±2.39)cmH_(2)O and(22.47±3.27)cmH_(2)O,respectively,which were lower than(24.25±2.62)cmH_(2)O and(25.27±3.15)cmH_(2)O in the control group,and the differences between the groups were statistically significant(P<0.05).The mean arterial pressure level of the observation group after treatment was(88.60±10.43)mmHg,which was higher than(81.86±10.25)mmHg of the control group,the central venous pressure level was(7.11±1.46)mmHg,which was lower than(14.33±2.28)mmHg of the control group,and the differences between the groups were statistically significant(P<0.05).The mechanical ventilation time of the observation group was(9.12±1.78)d,which was shorter than(10.21±2.12)d of the control group,and the difference was statistically significant(P<0.05).Conclusion APRV can improve blood gas analysis and respiratory mechanics of ARDS patients,stabilize hemodynamics,and shorten mechanical ventilation time.
作者
王蕾娜
王倅旭
WANG Leina;WANG Zuxu(Department of Critical Medicine,Rushan People's Hospital,Weihai Shandong,264500,China)
出处
《反射疗法与康复医学》
2023年第7期136-139,共4页
Reflexology And Rehabilitation Medicine
关键词
急性呼吸窘迫综合征
气道压力释放通气
血气分析
呼吸力学
血流动力学
预后
Acute respiratory distress syndrome
Airway pressure relief ventilation
Blood gas analysis
Respiratory mechanics
Hemodynamics
Prognosis
作者简介
王蕾娜(1985-),女,山东烟台人,本科,主治医师,研究方向:严重感染和感染性休克、急性呼吸窘迫综合征、急性肾功能衰竭、多器官功能障碍综合征等多种危重病的治疗。
