共查询到19条相似文献,搜索用时 187 毫秒
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目的 研究小潮气量 PEEP机械通气配伍山莨菪碱治疗高海拔地区急性呼吸窘迫综合征(ARDS)的临床疗效.方法 收集我院确诊的ARDS患者54例,随机分治疗组30例和对照组24例,治疗组采用小潮气量 PEEP机械通气配伍山莨菪碱治疗.对照组用传统小潮气量 PEEP机械通气治疗.结果 治疗组PaO2(91.80±2.31)mmHg,较对照组(83.93±1.40)mmHg在通气24小时时明显升高(P<0.001);病死率明显下降(P<0.05);通气时间明显缩短(P<0.05).结论 小潮气量 PEEP机械通气配伍山莨菪碱治疗高海拔地区ARDS较传统方法明显降低病死率. 相似文献
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目的探讨双相气道正压(BIPAP)通气模式治疗急性呼吸窘迫综合征(ARDS)的疗效.方法将20例ARDS患者随机分为BIPAP组和间歇性正压通气(IPPV)组行机械通气治疗,每组10例.观察机械通气期间患者镇静剂和肌肉松弛剂用量,气道力学参数中吸气峰压(PIP)、平台压(Pplate)和呼气末正压(PEEP)的变化以及机械通气的时间.结果15例(75%)治愈出院,5例死亡.BIPAP组机械通气时间[(13±7.5)d]显著低于IPPV组[(21±11.6)d](P<0.05).BIPAP组安定、吗啡和万可松用量显著低于IPPV组(P<0.05);IPPV组PIP、Pplate和PEEP均显著高于BIPAP组(P<0.05).结论BIPAP通气模式人机关系协同性好,缩短了治疗ARDS的机械通气时间. 相似文献
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目的总结早期气道开放机械通气下纤维支气管镜(纤支镜)在重型颅脑损伤并误吸救治中的经验及安全性。方法对26例重型颅脑损伤并误吸患者实施早期气道开放持续机械通气支持下纤支镜治疗,观察治疗过程中患者的心率(HR)、血压(BP))、血氧饱和度(SaO2)等生命体征的变化。结果 26例患者进行32次纤支镜治疗,操作过程顺利,生命体征平稳,未发生并发症;观察3~5天未发生吸入性肺炎及阻塞性肺不张。结论机械通气下纤支镜治疗,对重型颅脑损伤合并误吸患者在保障呼吸道通畅、纠正低氧血症、防止吸入性肺炎及阻塞性肺不张等方面有重要价值,并具有良好的安全性。 相似文献
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目的探讨BiPAP呼吸机对腹部外伤术后早期成人呼吸窘迫综合征(ARDS)的临床应用意义。方法回顾我院2003年5月—2007年5月收治的53例早期成人呼吸窘迫综合征患者采用BiPAP无创正压通气纠正低氧血症、改善氧合等综合治疗的经验。结果3例因主支气管处痰液较多即行气管切开机械通气,9例因发展至进展期行气管插管通气,其中3例因合并多脏器功能障碍(MODS)治疗无效死亡,其余均治愈。结论早期及时有效的使用B iPAP呼吸机正压辅助通气是防治腹部外伤术后早期ARDS的重要方法。 相似文献
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急性呼吸窘迫综合征(ARDS)是由各种致病因子激活细胞和体液因素,导致体内过度或失控性炎症反应,故认为ARDS是全身性炎症反应综合征在肺部的表现.对于ARDS的治疗,目前临床主要采用以呼气末正压(PEEP)机械通气为主的综合性治疗措施,尚无有效的药物治疗方案. 相似文献
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低潮气量加呼气末正压通气治疗创伤后急性呼吸窘迫综合征的临床研究 总被引:6,自引:0,他引:6
目的 探讨低潮气量 (LTV) 呼气末正压 (PEEP)机械通气 (MV)治疗创伤性急性呼吸窘迫综合征 (ARDS)的疗效。 方法 1997年 10月~ 2 0 0 3年 10月 ,我科 2 6例创伤性ARDS患者 ,分为传统潮气量 (12~ 15ml/kg)机械通气组 (A组 ) 11例 (1997年 10月~ 2 0 0 0年 8月 ) ;低潮气量 (5~ 8ml/kg) PEEP机械通气组 (B组 ) 15例 (2 0 0 0年 9月~ 2 0 0 3年 10月 )。比较两组的血气、血流动力学指标 ,呼吸机所致肺损伤 (VILI)发生率 ,发生多器官功能不全综合征(MODS)的时间、发生率和ARDS的病死率。 结果 两组中血流动力学和血气指标中氧分压(PaO2 )比较 ,差异无显著性意义。B组二氧化碳分压 (PaCO2 )高于A组 (P <0 .0 5 ) ,B组中发生MODS的时间延长 (P <0 .0 5 ) ,MODS的发生率和ARDS的病死率降低且无VILI发生。 结论 低潮气量 PEEP机械通气在创伤性ARDS的治疗中 ,改善氧合与传统方法比较 ,差异无显著性意义 ,PEEP(5~ 18cmH2 O)和轻度高碳酸血症 (PHC)对血流动力学无明显影响 ,且能有效地减少VILI,延长MODS发生的时间 ,适合在ARDS中应用。 相似文献
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In a prospective investigation of 19 patients with traumatic (n = 11) and septic (n = 8) shock at risk of developing the adult respiratory distress syndrome (ARDS), serial chest films were monitored. Eight patients developed ARDS, 2 following traumatic shock and 6 following septic shock. Only 2 of these 8 patients exhibited radiographic abnormalities consisting in bilateral widespread infiltrates of the alveolar type. In the 2 patients ARDS had already developed before artificial ventilation with positive end expiratory pressure (PEEP) was instituted. In the other 6 patients, in whom ventilator treatment with PEEP was initiated prophylactically or early in the disease, the chest films remained virtually normal despite development of a marked pulmonary insufficiency. It is concluded that early ventilator treatment with PEEP counteracts the classical radiographic abnormalities of ARDS, probably by reducing alveolar oedema and atelectasis. Thus, presently, with use of early or prophylactic ventilator treatment with PEEP as a therapeutic measure against ARDS chest radiography may be of limited value in the diagnosis. However, it should be essential for early recognition of therapy requiring complications. 相似文献
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肺挫伤致急性呼吸窘迫综合征临床分析 总被引:1,自引:1,他引:0
目的 探讨肺挫伤致ARDS相关危险因素。方法 总结 1 2 6例肺挫伤的临床资料 ,并将住院时间 >2 4小时的 1 1 0例分为ARDS组和非ARDS组 ,对其致伤原因、伤情及治疗结果进行对比分析。结果 本组ARDS发生率 30 .2 % ,肺挫伤并严重多发伤ARDS发生率较单纯肺挫伤高 (P <0 .0 1 )。交通伤为肺挫伤最主要原因 ,ARDS组挤压伤多 ,坠落伤较少 (P <0 .0 1 ) ;ARDS组损伤严重 (ISS >2 5 ) ,ISS评分明显高于非ARDS组 (P <0 .0 1 ) ,其浮动胸壁、休克、多发伤发生率明显高于非ARDS组 (P <0 .0 1 )。结论 合并严重多发伤 (ISS >2 5 )、浮动胸壁、休克等是肺挫伤致ARDS重要危险因素 ,应针对其进行早期有效治疗 相似文献
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目的:探讨严重烧伤患者并发ARDS的原因、发病特点和防治措施。方法收集2005-01~2012-01间收治并发ARDS的严重烧伤患者31例的临床资料,根据临床表现和实验室检查,提出可能的致病原因并根据诊断结果选择适合的治疗方案。结果本组患者中合并吸入性损伤者并发ARDS 13例,发生于休克期者4例,发生于感染者12例,发生于手术后者2例。本组患者经过治疗,除2例死于MODS外,其余全部愈合出院。结论严重烧伤患者并发ARDS发生率很高,发病原因与烧伤面积、深度、是否合并吸入性损伤有关,也与休克、感染、手术时间长短及术中输液量、营养支持及创面处理有关。对严重烧伤患者并发ARDS的早期诊断和治疗,能有效减少此类患者并发MODS,促进创面早期愈合有重要意义。 相似文献
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目的 研究分析高原肺水肿(HAPE)继发急性呼吸窘迫综合征(ARDS)的治疗方法及氧动力学变化特点.方法 对6例HAPE继发ARDS患者进行了机械通气、药物治疗及氧动力学监测.结果 6例患者经1 w治疗后,发绀明显好转,PaO2、SaO2、PaO2/FiO2较1 w前显著升高(P<0.01).结论 对HAPE经常规治疗1 w左右不见好转的,应高度警惕并发症的发生.HAPE继发ARDS时,氧动力学已发生明显紊乱,病情危重,治疗的关键是早期机械通气,改善组织氧合,限制入量,同时予药物治疗. 相似文献
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严重烧伤并发急性呼吸窘迫综合征的临床报告 总被引:1,自引:0,他引:1
陈侠英 《中国烧伤创疡杂志》1999,(1):23-24
急性呼吸窘迫综合征(ARDS)是严重烧伤病人的一种并发症,它发生于休克复苏过程或继发感染、手术打击等情况后。作者自1994~1997年共治疗6例(ARDS)病人,都伴有休克。有的病人还并发肺炎、肺水肿、吸入性损伤、败血症、脓毒症等。作者认为,烧伤面积超过30%、休克、感染及吸入性损伤都是发生ARDS的危险因素。治疗原则包括早期诊断,及时吸氧、保持呼吸道通畅;控制感染、消除肺间质水肿;解除肺脏血管痉挛,改善肺脏微循环功能等。全组治愈5例,好转1例。 相似文献
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高海拔地区急性呼吸窘迫综合征的诊治 总被引:1,自引:1,他引:0
目的:探讨高海拔地区急性呼吸窘迫综合征(ARDS)的诊治特点。方法:30例急性呼吸窘迫综合征,其中多器官功能衰竭11例,除1例为心、肺、脑、肾、肝、胃多器官功能衰竭外,其他多为并发心功能衰竭,本组PaO2/FiO240~300,PaO240~300,PaO24.8~8kPa,PCO23.33~10.6kPa,Sao20.4~0.85,CVP0.5~1.96kPa。单独应用HFV治疗2例,IPPV治 相似文献
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Late-stage adult respiratory distress syndrome caused by severe acute respiratory syndrome: abnormal findings at thin-section CT 总被引:7,自引:0,他引:7
PURPOSE: To evaluate thin-section computed tomographic (CT) abnormalities in patients in the intensive care unit during the late stage of adult respiratory distress syndrome (ARDS) caused by severe acute respiratory syndrome (SARS). MATERIALS AND METHODS: Eight patients in the late stage of ARDS (ie, more than 2 weeks after onset) were imaged with thin-section CT. Images were evaluated for ground-glass opacification, consolidation, interstitial thickening, evidence of fibrosis, and any other abnormalities. Patient records were reviewed, and relevant respiratory and ventilatory parameters, total steroid dose, and outcome were recorded. RESULTS: All patients received high-dose pulse methylprednisolone (minimum, 2.5 g total), and all patients who received ventilation received low-pressure, low-volume ventilation. Five patients received prolonged mechanical ventilation (for more than 14 days), one received ventilation for 72 hours, and two patients did not receive ventilation. Three patients died, four were discharged from the hospital, and one continued to require ventilation. Ground-glass opacification and interstitial thickening were present at CT in all eight patients. Consolidation was present in six patients. Three patients had evidence of fibrosis. Patients who received long-term ventilation, those who received short-term ventilation, and those who did not receive ventilation had similar pulmonary changes at CT. Pulmonary cysts, most of which were small (<1 cm), were present in five patients. Cysts were present in one patient who received only short-term low-pressure and low-volume ventilation and in one patient who received no mechanical ventilation. CONCLUSION: The CT features of late-stage ARDS caused by SARS are similar to those seen in late-stage ARDS of other causes, with no apparent differences between patients who do and patients who do not receive prolonged mechanical ventilation. The presence of cysts in one patient who received short-term and one patient who received no mechanical ventilation suggests that severe SARS-induced ARDS may independently result in cyst formation. 相似文献